Name:
Email:
Address:
City: State: Zip:
Country:
Daytime Phone: Fax:
Arrival Date:
Departure Date:
No. of Nights:
No. of Rooms:
Room Category:
Single
Double
Triple
Extra Bed
Baby Crib

Names of Guests Traveling:
Have you visited us before? Yes No
Credit Card Information:
Type:

Card Holder :

Number:

Expiration Date:

Comments/Special Requests:

For Further Information Contact Ruth Martinez:
Tel: 01152 (613) 135-0280 Fax: 01152 (613) 135-0855
Email: reservacioneshp@prodigy.net.mx