Coast Boutique Apartments Secure Online Payment Form - Bali Garden Beach Resort, a Hotel Accommodation in Kuta

Coast Boutique Apartments Secure Online Payment Form

Payment Details
I hereby authorized : to charge my credit card for the accommodations
Please debit (Amount) (required)

Confirmed By (required)
(Reservation Staff Name)
Against Credit Card (required)
Cardholder's Name (required)
Card Number (required)

Expire Date(required)

CCV Number(required)

3-digits verification number printed on the back of your card for Visa / MasterCard and 4 digits for AMEX

Personal Information
First Name (required)
Last Name (required)
Email (required)
Reservation Detail


Flight No.

Flight No.
Room Type
Number of Room
Extra bed required

Additional Comments / Request


By clicking 'Pay Now' you agree with our Terms and conditions, Payment & Reservation Policy below.

Terms and Conditions for Credit Card Payment

I consent to pay the transaction in INDONESIA RUPIAH according to the rule of Indonesia Bank and the rate will be charged equal to the exchange rate at the time of billing. This may cause a slight variation in the dollar-value shown on your card statement due to continues fluctuation in conversion rates by the bank..



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