Credit Card Billing Authorization Form

Cardholder Information

*Email on Account: To ensure your payment is applied correctly to your account, please use the email address you have on file with the Boatmatrix.

Charge Information

(You must select a location and payment type in order to complete this form. If you would like multiple locations, please submit a form for each location)

Store Location

Payment Type

Credit Card Information

Test Card Information:
Number: 4111 1111 1111 1111
Expiration: 12/29
Security code: 999

(Specify specific amount for Pay Now)
**"By clicking 'Submit' on this form, you acknowledge and agree that you have read and consent to our Terms and Conditions