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ALL REQUESTS MUST BE RECEIVED BY 4PM ON JANUARY
14, 2005
Please read all hotel information before filling out
this form.
Name _______________________________________________________________________
Sharing with (List all occupants) __________________________________________________
Arrival date (if different for shares) _____________________________________________
Address ____________________________________________________________________
City __________________________________ State ______ Zip ___________________
Phone _______________________ Email ________________________________________
Credit Card # _____________________________________________ Expiration __________
__ AmEx __ Visa __ MasterCard __ Discover __ Diners Club
Signature __________________________________________________________________
Arrival Date ________________ Time ________________ (Check-in is after 4PM)
Departure Date ________________ Time ________________ (Check-out is before 12:00 Noon)
Room Type (This is only a request, not a guarantee) '1'
for first choice, '2' for second choice:
__ Standard Single - $79
__ Standard Queen - $99
__ Standard King - $119
__ Standard Double - $119
__ Deluxe King - $139
__ Access King - $139
__ Deluxe Double - $139
__ Junior Queen Suite - $139
__ Junior King Suite - $139
__ 1-BR Suite - $225
__ 2-BR Suite - $295
__ Request cot (limit 2 per room, no cots in Standard Single or Standard Double)
__ Request crib
If request of Double is not available, please add a cot to my room:
__ yes __ no
Arisia Block (pick one)
__ Quiet
__ Party
__ Party Host
__ Shabbat
__ Smoking
__ Staff
By requesting a reservation attendee agrees to conditions and limitations listed in Hotel Reservation Policies.