REFERENCE NAME REFERENCE BOOKING NUMBER Block dates Cut off date O Mr O Mrs : *IBO : MB0000287576 : 10/11- 13/11/2016 : 14/10/2016 Last name: _____________________ First name :________________ Date of arrival: Date of departure: Please indicate reservation dates: Standard Room NH Brussels City Centre hotel - 10/11/2016 O Single € 105,00 per room, per night O Double € 120,00 per room, per night - 11/11/2016 O Single € 85,00 per room, per night O Double € 100,00 per room, per night - 12/11/2016 O Single € 85,00 per room, per night O Double € 100,00 per room, per night € 6 city tax / night NOT included. Breakfast is included. These rates include services, VAT and are per night and per room. CANCELLATION FREE OF CHARGE UNTIL 5 DAYS PRIOR TO ARRIVAL. AFTER THIS TIME THE RESERVATION VALUE WILL BE CHARGED AT 100% PAYMENT METHOD O Payment by Guest We kindly ask you to guarantee the reservation by credit card in order to secure the room for you in case of late arrival. Guarantee by credit card: O Visa O Eurocard O Mastercard O American Express O Diners Club Credit Card holder:________________________________ Credit Card Nbr :_________________________________ Expiration Date :____/____ In case of no show the owner of the card authorizes the hotel to charge the credit card for the total stay. CONFIRMATION Please mention your email address or fax number should you wish to receive a confirmation of your reservation; email: _____________________________________ fax number: ________________________________ Please return the reservation form to [email protected] The above rates are valid th until the 14 of October 2016. After the above dates the rooms will be released. And if guests would like to add rooms after this date, it will be subject to availability and the same price can’t be guaranteed anymore.
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