Riverstone Lodge accommodation reservation form - Pension ...

pensionlawyers.co.za

Riverstone Lodge accommodation reservation form - Pension ...

PAGE 1 OF 2PENSION LAWYERS ASSOCIATION(PLA) RIVERSTONE LODGE BOOKING FORMACCOMMODATION RESERVATION FORMTHE 2013 PENSION LAWYERS’ ASSOCIATION CONFERENCE(Misty Hills Country Hotel, Muldersdrift, Gauteng)3 to 5 March 2013Please complete this form and return it by FAX OR EMAIL BEFORE 03 FEBRUARY 2013 toThea Vlaanderen at the Riverstone Lodge - Fax : 086 234 0303.SCANNED BOOKING FORMS MAY BE EMAILED TO conference@riverstonelodge.co.zaKindly make your reservation and payments directly with the hotel. Please complete the formwith all the information requested to enable your booking to be processed successfully.ACCOMMODATION RATESFull (Book and pay by 10 February 2013)Single Standard Room – R1 150.00 per room per nightDouble Standard Room – R1 840.00 per room per nightThese rates are per room per night, and include breakfast, VAT @ 14 % and a Tourism Levy.Full prepayment is required when booking. Any outstanding amounts must be settled on departure by thedelegate.DELEGATE DETAILSOrganisation/ Employer:Surname: Initials: Title:Id or Passport Number:Accompanying person’sname/s:Postal Address:Email Address:PostalCode:Telephone: Fax: Cell:RESERVATION DETAILSDate of arrival ___________________________Date of departure ____________________________Std. Room, single occupancy / no. of rooms __________Std. Room, double occupancy / no. of rooms _________CREDIT CARD DETAILSCredit Card DINERS MASTER VISAThis is a company credit card in the name of:_______________________________________________________This is a private credit card in the name of:________________________________________________________Card No.: Expiry Date:CVC-code:


PAGE 2 OF 2PENSION LAWYERS ASSOCIATION(PLA) MISTY HILLS COUNTRY HOTEL BOOKING FORM• These credit cards will only be accepted if the CVC-code is given (last 3 digits on the reverse side of the credit card).• The room cannot be guaranteed without all the requested details required on page 1 being provided (including yourvalid credit card details), the cardholder’s signature, completion of the CREDIT CARD AUTHORISATION below, aswell as SCANNED AND FAXED COPIES OF BOTH SIDES OF THE CREDIT CARD AND THE CARDHOLDER’S IDDOCUMENT OR PASSPORT.• Please note that FULL PREPAYMENT is required.AUTHORISATION OF CREDIT CARD HOLDER PAYING FOR THIS RESERVATION:I / We _________________________________________ (FULL NAME OF CREDIT CARD HOLDER), hereby authorizeRECREATION AFRICA LEISURE INDUSTRIES (PTY) LTD to debit our credit card (the details as specified above) with theamount calculated below:FOR AMOUNT:(IN WORDS)R_________________________________________________________________________________________________________________________________________CARD HOLDER’S SIGNATURE: _____________________________________________________________________DIRECT DEPOSITSPayments can be made to the Riverstone Lodge by means of a direct deposit - Account details as follows: RiverstoneLodge cc. Nedbank Bank Business unit West Rand, BRANCH CODE 128605, ACCOUNT NUMBER 128 609 6022Please ensure that you’re SURNAME, WITH THE SUFFIX “PLA” IS USED AS A REFERENCE ON ALL PROOF OFPAYMENTS. PROOF OF PAYMENT must be sent to Thea Vlaanderen in order to secure your reservation.PLEASE INDICATE, BY TICKING THE BOX BELOW, IF A DIRECT DEPOSIT IS THE SELECTED FORM OFPAYMENT.DIRECT DEPOSIT WILL BE MADEENQUIRIESThea VlaanderenTel 011 – 668 3111Fax 086 234 0303Email conference@riverstonelodge.co.zaTERMS & CONDITIONS1. Accommodation will be allocated on a “first come, first served” basis.2. Rates quoted for Riverstone Lodge are per person per night and include breakfast. Rates include VAT @ 14% and aTourism levy.3. All rooms will be subject to availability.4. Reservations are only secured via credit card authorization, accompanied by copies of both sides of the credit card,and a copy of the card holder’s ID or passport, or by direct deposit (proof of payment must be sent)6. The following cancellation policy applies:-60 to 30 days prior to arrival 25% of the value of the reservation will be charged to the client29 to 15 days prior to arrival 50% of the value of the reservation will be charged to the client14 to 01 days prior to arrival 100% of the value of the reservation will be charged to the client7. NO SHOWS: 100% of the value of the reservation will be charged to the client8. All cancellations must be done in writing.I hereby acknowledge that:• I have read and that I understand and accept all the terms and conditions of my registration.• All information supplied by me is true and correct and that I will not hold the Pension Lawyers’ Association or thehotel liable for any mistakes I have indicated on this form.Signature: ______________________________________Date:_________________________________

More magazines by this user
Similar magazines