HOTEL REGISTRATION FORM 

BELLYDANCE 
Reservation number 95221 
Please return this form to the Amrâth Grand Hotel by fax: 0031 45 5741099 
Or by e-mail: info@grandhotel-heerlen.nl 

Surname ......................................

First name ...................................

Address ......................................

Telephone Telefax:............................

e-mail .......................................

Arrival on Saturday 11 February 2012 Or: ----- 2012 
Departure on Sunday 12 February 2012 Or: ----- 2012 

Rooms
O single room à € 74.00, per night, including breakfast, excl. city tax 
O twin room à € 89,00 per night, including breakfast, excl. city tax 
O Triple room à € 114,00 per night, including breakfast, excl. city tax 
City Tax is € 1,15 p.p.p.n. 

As a guarantee we ask for your credit card number. 
Without this guarantee we might cancel your reservation after 06.00 PM. 
You can cancel the room until 24 hours prior to arrival at the latest 04.00 PM. 
In case of late cancellation or no-show we will charge your credit card for the first night. 

Type creditcard America express/ Euro/Mastercard / Visacard / Dinersclub 
Creditcard nr .................. - .................. - .................. - .................. 
Expire date .................. / .................. 

Signature :.................................................................................... 
Date : .................. - .................. - .................. 


We inform you that rooms will be blocked till the 11 January 2012 
Only to be filled in by the Hotel : 
Reservation accepted YES / NO 
Reservation number 
comments 

Groene Boord 23 | 6411 GE Heerlen | Telefoon: +31-45-5713846 | telefax: +31-45-5741099 | 
e-mail: sales@grandhotel-heerlen.nl www.amrathhotels.com | KvK: 14062061 | BTW: NL003648047B33 
We handle the Uniform Conditions for Hotel and Catering Industry UVH