First Name*:

Last Name*:

Address*:

 

City*:

State/Province*:

Country:

Zip/Postal Code*:

E-mail Address*:

Phone Number*:

Fax Number:

Preferred Method of Contact:

E-mail FAX Phone

Arrival Date:

Est. Arrival Time:

Flight No (if known)

Departure Date:

Number of Adults:

Number of Beds:

Preferred Room:

Number of Rooms:

Repeat Stayer? (check box):

Yes Month and year of last stay.

Credit Card Details:

Cardholder's Name :

Credit Card Type:

Card No.:

Expiration Date:

A credit card deposit of 50% (one night minimum) is required to hold and guarantee this reservation. If you prefer to submit your credit card details by phone or fax, please advise us in the Additional Comments below and we will contact you.

NB: Your reservation is not confirmed until a confirmation of deposit is received. The remainder of the deposit is due 30 days prior to arrival and will automatically be charged. If this reservation is within 30 days of arrival, the entire balance will be due at booking.

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Additional Comments:

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* INDICATES REQUIRED FIELD