WDW Credit Card Authorization Form

Thank you for registering for Wine, Dine and Whinny!

Completing this Credit Card Authorization form will expedite our check out process, and allow you to skip the check out line at the end of the night. Please be prepared to take home any items you may purchase at the conclusion of the event. We will securely hold on to this information, and if you are the successful bidder at the Silent or Live Auctions or if you make a donation at the Reverse Auction, we will use this credit card information as your form of payment. If you do not purchase anything, this information will be destroyed. NO CREDIT CARD INFORMATION WILL BE RETAINED BY EE FOR ANY PURPOSE

Any auction items won at the event will be charged to your card in a timely manner. We will be accepting Visa, MasterCard, American Express and Discover. Should you decide to pay by check or cash, you may do so when check out opens at the conclusion of the Live Auction.

Wine, Dine and Whinny 2022 Credit Card Authorization Form

* Indicates required field

Name on the Credit Card *

First

Last

Type of Card *

Visa Mastercard Discover American Express

Credit Card Number *

Expiration Date *

Security Code (3 numbers of the back of your card) *

Billing Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

By signing this form, you authorize Exceptional Equestrians of the Missouri Valley, Inc. to charge your card for any purchase made at Wine, Dine and Whinny on Saturday, June 18th, 2022

Signature *

Date *

Submit