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ROOM RESERVATION FORM
Lagoon Superior Room/s
$A325.00 per night

Conference dates 9 - 12 AUGUST 2007*


* NB: We recommend that you arrive on Wednesday 8th August 2007
to ensure attendance for the first session starting at 1:00pm.

Rates also available 5 days pre and post conference dates.
For more information regarding the room types please see the
Hayman website

* Required fields

* Your Name:
* E-Mail Address:
* Contact Telephone or Fax Number:


  Number of Rooms required?


(If applicable)
Names of Additional Guests (including children)

  :Guest 1
  :Guest 2
  :Guest 3
  :Guest 4
  :Guest 5
  :Guest 6





Arrival Date:

Flight No. on Arrival in Hayman: 




Departure Date:

Flight No. on Departure: 


Do you have any special requirements?







* Calculate Total cost: ($A325 x number of nights x rooms required)
  $A

Please provide a credit card number to guarantee the accommodation requested, please note the room charges will not be charged until departure. Credit card payments will be subject to a 1% surcharge.

Payment by Credit Card:
Visa Mastercard
Card Number:
Expiry Date:
  Month/Year
Name on Card:


Please ensure that you have also registered for Perfusion Downunder on the Registration Link.

Please Note:Cancellation of rooms 30 - 14 days prior to arrival - one night cancellation fee per room cancelled will be charged to the individual credit card provided.

Cancellation of rooms less than 14 days prior to arrival - 100% of total room value cancelled will be charged to individual credit card provided



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