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Hotel Reservation Form
Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
E-Mail:*
Room Rates
Single (Deluxe Ocean View)
  Rate
Double or Queen (Deluxe Ocean View):
  Rate
Suite - King (Deluxe Ocean View):
  Rate
Single (Garden/Golf/Mountain View):
  Rate
Double or Queen (Garden/Golf/Mountain):
  Rate
Suite - King(Garden/Golf/Mountain View):
  Rate
Additional Person:
  Rate
Grand Total:
Date of Arrival:*
Date of Departure:*mm/dd/yyyy
Billing Information
First Name:*Same name as on your card
Middle Initial:
Last Name:*
Address Line 1:*Where your statement is mailed
Address Line 2:Apt. or Suite No.
City:*
State:
Province:
Country:*
Zip Code:*
Phone:
Credit/Debit Card Information
Card Number:*No dashes or spaces please
Expiration Month:*From your card
Expiration Year:*From your card
Card Brand:*
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