HOTEL REGISTRATION FORM 

Belllydance 
Blockbookingnr GF256 


Please return this form to Tulip Inn Heerlen City Centre, info@TulipInnHeerlenCityCentre.nl 
Or by telefax +31-45-5741099 


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 € 59.00, per night incl. breakfast, excl. city tax 
O twin room à € 79,00 per night incl. breakfast, excl. city tax 
O triple room à € 99,00 per night incl. 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 

Tulip Inn Heerlen City Centre | Wilhelminaplein 17 | 6411 KW Heerlen | 

Telefoon: 0031-45-5741355 | telefax: 0031-45-5741099 | e-mail: info@tulipinnheerlencitycentre.nl 
| KvK: 14062061 | BTW: NL003648047B33 

Wij hanteren de uniforme voorwaarden horeca