Room Reservation - Perfusion Downunder Winter Meeting 2010

ROOM RESERVATION

Deluxe Studio - Forest View
$NZ235.00 + GST RO per night

Conference dates 5th - 8th AUGUST 2010*

* NB: We recommend that you arrive on Wednesday 4^th August 2010 to ensure attendance for the first session.
Dates for accommodation have been reserved from 1st August through to the 20th August (just in case people want to come early or leave later) ... however the conference dates are Thursday 5th August - Sunday 8th August.

* Required fields

* Your Name:

* E-Mail Address:

* Contact Telephone or Fax Number:

Number of Rooms required?

NB: Rates are per room per night based on double or single occupancy

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

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

Arrival Date:
Departure Date:
Do you have any special requirements?

* Calculate Total cost: ($NZ235 x number of nights x rooms required) $NZ
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 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