Reservation for Hotel: Club Bali Mirage

CLUB BALI MIRAGE -

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INFORMATION:

Adult

Extra Bed

CHD

Child

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Room Information:

RATE FOR THIS HOTEL AND ROOM TYPE (all price in USD Dollar)

Rates are per room per night, including tax and service charges

STAYING PERIOD ( Fri: Jan 06, 2012 - Sat: Mar 31, 2012)

1EB

CHD

133

191

inclusion: All Inclusive, Breakfast, Lunch, Dinner, Tax and Service Charges

RESERVATION FORM:
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Title

First Name

Last Name

Other Guest Name:

Email

Telephone

Fax

Address:

Country

City

State/Prov

Postal Code

Arrive by

Need Transfer

Check in date *

Check out date *

Language

English Chinese German Japanese

Number of rooms

rooms

Number of adult

persons

Children

Write the details of your room request * (example, 1 Single, 1 Double, 1 Twin, 1 Extra Bed etc):

Arrival detail:

* Please enter your flight number and arrival time if you are arriving by air. Or your estimated arrival time if you are arriving by land or sea.

Smoking option

no preference smoking non-smoking

Comment:

Important Notes:
* Child needs an extra bed travelling with 2 adults will be charged as an adult extra bed.
* Child without extra bed travelling with 2 adults will be charged on extra meals only.

available room

Deluxe Room
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Romantic Room
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