Right to Charge Credit Card

For all bridal and spa parties of three or more we ask that a credit card number be given to reserve the day. In the event that a reservation is not cancelled 48 hours prior to the reservation. We reserve the right to charge this credit card on file.

Credit Card Information

Name on card (print): ______________________________________________

Credit card billing address : _________________________________________

Credit card type : _________________________________________________

Credit card #: ____________________________________________________

Expiration date : __________________3 digit security code _______________

Cardholder's signature : ___________________________________________

Please fax form to 219-661-7318, or mail to 111 West 94th Place, Crown Point, Indiana, 46307. For phone reservations call 219-663-7317

* Phone reservations will be confirmed when completed form is signed and returned to State of Mind. Reservations are not considered confirmed until completed form is received by State of Mind.