BOOKING FORM IQCLSW 2014, 7-12 September 2014
HOTEL MARINAGRI – LUXURY NATURE AND SPA
75025 Policoro (MT), Italy
We kindly ask you to fill out the form with all the information required and send it back to: firstname.lastname@example.org or via fax at to +39 050 509417 (please send an e-mail to inform the registration has been faxed).
Name ___________________ Surname ___________________ Address ___________________ ZIP code ___________________ City ___________________ Country ___________________ Birth Date ___________________ Birth Place ___________________ Email ___________________ Mobile number ___________________
Phone Number ___________________ Fax ___________________
DETAILS OF THE STAY
The rates reserved for IQCLSW 2014 are valid for the period 05.09.2014-14.09.2014 and for thall reservations sent by May 5, 2014. In case you would like to anticipate or extend your
stay outside these dates the rooms are subject to availability and the rates may differ.
Prices reserved for reservations received within 05/05/2014
Please write below your arrival / departure date
Arrival Date __________________ Departure Date ___________________
(deluxe) ? 100,00 per day
Room Mate Name ? Roommate ? 40,00 per day ___________________ supplement
Double Deluxe ___________________ room + Guest 1 ___________________ 1 additional bed Guest 2 ___________________ ? ? 160,00 per day (3 people) Guest 3 (limited number available)
Signature for acceptance
Double Deluxe room
+ 2 additional beds
(4 people) ? 180,00 per day
_________________ Guest 1 _________________ Guest 2 _________________ Guest 3 _________________ Guest 4
The rates include:
Infant 0-3 year: free
Infant 4-7 years: 15 euro/night for bed supplement
Cancellation policy: The cancellation if free 48hours before the arrival date; one night deposit will be charged in case of late cancellations.
Credit Card Details
Card Holder Name and Surname ___________________
Birth Date ___________________
Issue date ___________________
Expiration date ___________________
Card Number ___________________
I authorize the credit card use for reservation purpose only. No money will be charged until the departure date.
Signature (required) for acceptance ___________________
N.B.: Marinagri Hotel will issue invoices or receipts to certify your stay. At the moment of the reservation
please specify if you need a simple receipt with heading or an invoice (VAT number will be necessary).
The rooms will be available for occupancy from 1:00 PM of the day of arrival (or before if available) and must be vacated by 12:00 AM on the day of departure.
Signature for acceptance