Arrival Date: please put day/month/year

Departure Date: please put day/month/year

Unit Required Executive Suite Executive Unit Deluxe Motel Deluxe Hotel Family

Number of Adults 1 2 3 4 5 6 7 8 9 more

Number of Children U5 none 1 2 3 4 5 6 7 8 9 more

Number of Children 5-12 none 1 2 3 4 5 6 7 8 9 more

Title: Dr., Mr., Mrs., Ms Dr. Mr. Mrs. Ms. other

Surname:

Christian Name:

Company Name:

Address: Street

Town/City:

State:

Post Code:

Country:

Telephone Number:

Mobile Number:

Email Address:

Payment Method: Cash American Express Diners Visa Bankcard

Please Note: When notified of availability and a reservation has been placed one of
the following will be required to secure the booking.

v Credit Card Details.
v Cash payments for accommodation will be required upon arrival plus a $50 security deposit.
v Company Charge Back Authority must be received in writing prior to arrival date.

Enter any other comments or requests here:

24 HOURS NOTICE MUST BE RECEIVED FOR CANCELLATIONS