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Candi Beach Cottage Reservation Form

Please fill in all fields
  Arrival Information  
 
Date Arrive (mm//dd/yy)
(ie. Jan 12, 05 or 12 Jan 05)
 
Flight No.
 
Date Depart (mm/dd/yy)
 
Flight No.
     
  Desired Room Accommodation
 
No. People
 Adults:   Children:
 
No. Rooms
 
Preferred Bed Type
 
Please select
   
  Your name and how to contact you
 
*First Name- required
 
*Last Name- required
 
Street Address 1
 
Street Address 2
 
City
 
State / Province
 
Country
 
Telephone (with area code)
 
Fax (with area code)
 
*E-mail- required
 
How did learn about paradise-bali.com ?
   
 
Notes:
All Rates Inclusive of 21 % Gov't Tax & Service Charge. No Hidden Charges
All reservations subject to room availability
Reservation not confirmed without Booking Confirmation Code
Rates subject to change without notice
 
Comments, requests, questions
 

   

     

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