DEWATA BEACH HOTEL
Reservation Request Form

Date Arrive (mm/dd/yr):

 (ie. Jan 12, 05 or 12 Jan 05)

  Flight No. :

Date Depart (mm/dd/yr):
Flight No. :
Number people : Adults:    Children:  
Number rooms :
Preferred bed type :
Type of room :

 

Personal Information. Please fill in all fields.
First Name :
Last Name :
Address :
City :
State/Province :
Country :
Postal Code :
Telephone :
Fax Number :
E-mail: - Mandatory
How did you learn about paradise-bali.com ? - Optional

(To Book more than one room type or request extra bed, please use comments below).

Notes:
Room reservation and desired bed type subject to availability
Reservation is not confirmed without Booking Confirmation Code
All Rates Inclusive of 21% Gov't Tax & Service Charge. No Hidden Charges

Comments, requests or questions:

            

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Thank you for letting paradise-bali.com serve you. Enjoy your visit to Bali.