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Please use this form for credit card payments of existing reservations or other items, which will be processed on our secure PaymentExpress gateway.
Reservation Name and Contact Details:
First Name
*
Last Name
*
Street Address
Address Line 2
City
State
Vic
NSW
SA
WA
Qld
Tas
ACT
NT
Other
Postcode
Phone Number
*
Email Address
*
Reservation Information
Note:
This is not a booking form
, it is for payments only (for accommodation already booked). To make a booking, please visit our
on-line booking system.
First Night:
*
+
Number of Nights
*
Number of Adults
Number of Children
Payment Description
*
Full payment
Deposit
Instalment
Balance for this booking
Other (please provide details below)
Allocation (check all that apply)
*
Accommodation
Linen Hire
Other Items
Optional Information
Optional Instructions/Reference/Questions
Payment Total
Cardholder Name
*
This Payment ($A)
*
Please show the amount only,
without
the "$" symbol (eg 100.00 for $100.00).
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