BOOKING FORM IQCLSW 2014, 7-12 September 2014
HOTEL MARINAGRI – LUXURY NATURE AND SPA
75025 Policoro (MT), Italy
We kindly ask you to fill out the form with all the information required and send it back to: miriam.vitiello@sns.it or via
fax at to +39 050 509417 (please send an e-mail to inform the registration has been faxed).
Name
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Surname
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Address
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ZIP code
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City
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Country
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Birth Date
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Birth Place
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Email
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Mobile number
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Phone Number
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Fax
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DETAILS OF THE STAY
The rates reserved for IQCLSW 2014 are valid for the period 05.09.2014-14.09.2014 and for
all reservations sent by May 5th, 2014. In case you would like to anticipate or extend your
stay outside these dates the rooms are subject to availability and the rates may differ.
Prices reserved for reservations received within 05/05/2014
Please write below your arrival / departure date
Arrival Date
Double room
(deluxe)
/single use
Roommate
supplement
Double Deluxe
room +
1 additional bed
(3 people)
(limited number
available)
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Departure Date
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€ 100,00 per day
€ 40,00 per day
€ 160,00 per day
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□
Room Mate Name
Guest 1
Guest 2
Guest 3
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Signature for acceptance
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1
Double Deluxe room
+ 2 additional beds
(4 people)
Guest
Guest
Guest
Guest
€ 180,00 per day
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1
2
3
4
The rates include:
Intercontinental Breakfast.
Room’s reduction
Infant 0-3 year: free
Infant 4-7 years: 15 euro/night for bed supplement
Cancellation policy: The cancellation if free 48hours before the arrival date; one night
deposit will be charged in case of late cancellations.
Credit Card Details
Card Holder Name and Surname
___________________
Birth Date
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Issue date
___________________
Expiration date
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Card Number
___________________
I authorize the credit card use for reservation purpose only. No money will be charged until the
departure date.
Signature (required) for acceptance
___________________
N.B.: Marinagri Hotel will issue invoices or receipts to certify your stay. At the moment of the reservation
please specify if you need a simple receipt with heading or an invoice (VAT number will be necessary).
General conditions
The rooms will be available for occupancy from 1:00 PM of the day of arrival (or before if available) and
must be vacated by 12:00 AM on the day of departure.
Signature for acceptance
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2