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Bali Dwira Hotel Reservation Form

Please fill in all fields
  Arrival Information
Check in Date
Arrival Flight No.
Check out Date
Depart Flight No.
  Desired Room Accommodation
No. People
 Adults:   Children:   Child's Age(s):
No. Rooms
Room Requested
Preferred Bed Type
  Your name and how to contact you
*First Name- required
*Last Name- required
Street Address 1
Street Address 2
State / Province
Telephone (with area code)
Fax (with area code)
*E-mail- required
How did you learn about ?
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
Hotel Cancellation Policy: Cancellation notice given less than 48 hours prior to scheduled arrival or no show the hotel may charge for one night stay. During High/Peak Season cancellation policy will be advised.
  Comments, requests, questions


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