reservation form


Print out the following form, fill out your information and fax to the Town Centre Inn. Name: ____________________________________________________ Address: __________________________________________________ City: _________________________________ Postal Code/Zip___________ Country: _______________________________________________ Telephone: (________)_____________________ Fax: (______)_______________ How long will you be staying with us? _________________night(s) What date(s) will you be staying with us ? Year:____ Month ________Date(s):______ Smoking: _______ Non-Smoking:___________ Type of Room you require: __________Single 1 person 1 Queen Bed __________Double 2 persons 1 Queen Bed __________ Twin 2 persons 2 beds _____additional person ($10.00 each) max 4 per room. __________ Kitchen Upgrade $10.00 extra __________ Small pets only (type and breed) We retain the right to refuse some pets Extra charge may apply. Payment: Name as it appears on Credit Card: _________________________________ Visa:_________ Mastercard: ___________ American Express:_____________ We accept debit cards and cash at check-in Card Number: ______________________________________________ Expiry Date: _______________________________________________ Signature: _________________________________________________ I authorize the Town Centre Inn to guarantee a room as outlined above. I am aware of the 48 hour cancellation policy and agree to pay 1 nights accommodation if I do not cancel before that time period. Town Centre Inn Fax: 1-250-287-3944 Toll Free Phone 1-800-287-7107 _______ Yes we can accommodate your request and look forward to your stay with us. _______ No I am sorry we cannot accommodate your request on this date and/or room type. Received and confirmed by: Phone _____Fax: _____Date: _________________ Signature: ____________________________