Reservation Request Form

For reservations submit this e-mail form or call direct
1-877-373-7900
E-mail reservations must be made at least 72 hours in advance.
You must be 21 years or older to rent a room.

This form is a reservation request only. You will be contacted by E-mail or Fax with rate information & availability in one or 2 working days. Please make sure you fill in your correct E-mail address or Fax number.

Name: Last / First		Address:
City:		State:	Zip Code:
Country:		Phone Number: Area Code / Number
*E-Mail Address:	OR:	*Fax:
* You may fax your credit card # & expiration date(using this form) to 1-435-673-8325
Credit Card Type:		Credit Card #:
Expiration Date: 01 - January 02 - February 03 - March 04 - April 05 - May 06 - June 07 - July 08 - August 09 - September 10 - October 11 - November 12 - December 2004 2005 2006 2007 2008
Arrival Date: Month/Day/Year		Number of Adults:
Number of Children 17 and Younger:		Number of Nights:
Room Type Request:
Two Queen Beds King Mini Suite One Queen Bed Double Queen w/ Microfridge Rollaway Crib   Smoking Non-Smoking
Additional Requests & Comments:

This form is a reservation request only. You will be contacted by E-mail or Fax with rate information & availability in one or 2 working days. Please make sure you fill in your correct E-mail address or Fax number.