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Mesquite Metro Airport Authorization and Release for Credit Card Use (fuel, oil and pilot supplies)

  1. AUTHORIZATION AND RELEASE FOR CREDIT CARD USE, (Fuel, oil and pilot supplies)

  2. (list each aircraft tail number and type)

  3. (list each name)

  4. In consideration of the airport making this credit option available to me, and understanding that while every effort will be made to keep this information confidential, but realizing the potential for unauthorized use, I do hereby, for myself, my heirs and representatives, release, waive and covenant not to sue, hold harmless and forever discharge the employees, agents, officers, administrators, and representatives of the city of Mesquite and Mesquite Metro Airport, from any and all liability, claim, demand, damage, action or right of action of whatever nature arising out of the use of the above described credit card.

  5. Select one of the following in reference to the above statement:

  6. This authorization and Release shall remain in full force and effect until the earliest of the credit card expiration date or such time as it is revoked by me or my legal representative in writing.

  7. Leave This Blank:

  8. This field is not part of the form submission.