Name :
	Address :
	City :
	Prov :
	Zip code :
	Phone :
	Fax :
	E-mail :
	Compagny :
	Number of people :
	Number of days :

		Room with one double bed
		Room with one queen size bed
		Room with one water bed
		Room with two single beds
		Room with two double beds
		Room with two queen size beds and living room
		Room with one water bed and therapeutic bath
		Room with one queen size bed and therapeutic bath
		Non smoking room

	Date of arrival :
	Date of departure :
	Reserved by :
	Date :

Comments :

	Credit card type :	MasterCard Visa AmericanExpress EnRoute Call me for the Number
	Credit card number :
	Expiration date :

                                                            

            

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