PRINT-OUT THIS FORM AND SEND

Rickshaw Inn Fax No. +81-577-32-2469

Would you send us your credit card number, name of card holder and expiration date as a deposit when you receive our reply, please. We will send you confirmation in return for it. Thank you.

*Full Name

   Family name      /   First name     
                                 Mr.
                                 Ms.
*Period of Stay Check-in Date:
Check-out Date:

I'd like to reerve by

*Int'l Credit Card:

  VISA
  MASTER CARD
*Card No.
. . . . . . . . . . . . . . . .
*Name of Card Holder  
*Expiration Date  
Note:
This card number is used to deduct cancellation fees in case you do not
show up without canceling your reservation (No-Show).
The room rates will not be charged to your credit card in advance.