LAS VEGAS FUN RALLY XXIII RESERVATION FORM

 

The 2004 dates are April 21, 22, 23, 24, & 25 - in Wednesday and out Sunday

Please complete this Room Reservation Request and send it, along with your check or credit card information to the address below.

 

GROUP NAME: Las Vegas PANTERA FUN RALLY

 

ABSOLUTE RESERVATION CUTOFF DATE: MARCH 21, 2004

 

TOTAL COST OF THE EVENT IS:                                           NON- MEMBER                                                    POCA MEMBER

(This includes room AND event charge              REGULAR PRICE:                                                                         DISCOUNT PRICE: **

   for 2 people)                                                           WEDNESDAY         THURSDAY         FRIDAY           WEDNESDAY    THURSDAY       FRIDAY

                                                                                             ARRIVAL                 ARRIVAL          ARRIVAL            ARRIVAL          ARRIVAL        ARRIVAL              

                                                                                            ---------------              -------------            -------------             -------------            -------------         -------------

1 BEDROOM  -----------------------------------------------      $395.00                $345.00             $295.00              $370.00             $320.00          $270.00

1 BEDROOM SUITE  --------------------------------------      $620.00               $520.00             $420.00              $595.00             $495.00          $395.00

2 BEDROOM SUITE----------------------------------------     $890.00                $765.00             $640.00              $865.00             $740.00          $615.00

EVENT COST ONLY - PER PERSON (NO ROOM)--     $135.00                $135.00             $135.00              $110.00             $110.00          $110.00

 

ROOM AND EVENT RATES ARE THE SAME FOR EITHER SINGLE OR DOUBLE OCCUPANCY

 

NOTE: TO STAY AT THE HOTEL ANY ADDITIONAL DAYS, SUNDAY THRU THURSDAY, AT EITHER END OF THE EVENT, JUST ADD $40.00 PER ROOM/PER NIGHT WHEN YOU MAKE YOUR RESERVATION THROUGH POCA.

 

Please make reservations at JACKIE VAUGHAN’S Plaza Hotel for: 

NAME:         ___________________________________________________________ CHAPTER/CLUB: ______________________

ADDRESS:_________________________________________________________________________________________________

CITY:           ______________________________________________________ STATE: _____________ ZIP:  _________________

PHONE:      HOME:(______) _____________________________ BUSINESS  (_______) __________________________________

"E" Mail ADDRESS:_________________________________________________________________________________________

ACCOMMODATIONS:  ONE BEDROOM   ________ ONE BEDROOM SUITE   _______ TWO BEDROOM SUITE   ________

 

IMPORTANT NOTE:    RESERVATIONS WILL BE HELD ONLY WHEN SECURED BY PAYMENT.

                                           PLEASE ENCLOSE YOUR PAYMENT WITH THIS RESERVATION REQUEST.

 

Please complete: ARRIVAL DATE: ___________________ ETA: __________ DEPARTURE DATE: _________________

TOTAL NUMBER IN YOUR PARTY:  _______ PRINT FIRST NAME OF EACH MEMBER IN PARTY  (FOR BUTTONS):

___________________________________________________________________________________________________________

(If more than two per bedroom, please add the "event only" cost for each additional person age 13 or older.)

 

I am (not) a current POCA member - Member Number:  __________ 

I am (not) entitled to the POCA member discount.  My total event cost will be $ __________.

**I am NOT a current POCA member, but wish to join POCA and take advantage of the POCA member discount price.  My total event cost of  $ __________ includes one years dues ($75.00/$90.00 foreign) plus the event POCA member discount price.

 

I WISH TO STAY AT THE PLAZA (____) ADDITIONAL DAYS.  I HAVE ADDED AN ADDITIONAL $40.00 PER ROOM/PER NIGHT TO THE APPLICABLE BASE AMOUNT AND MY TOTAL EVENT COST WILL BE $________________________

PAYMENT METHOD: CHECK _____ VISA _____ MasterCard ____

 

CARD #: ____________________________________________________________________________ EXP. DATE: ____________

 

PLEASE RETURN THIS ENTIRE PAGE, AND IF PAYING BY CHECK, MAKE IT PAYABLE TO "POCA", AND SEND IT TO:

 GARY ROYS, 6955 VERNMOOR, TROY, MI 48098. DO NOT send this form with "Signature Required" as this will only delay its delivery.

IF YOU HAVE ANY QUESTIONS, CALL GARY AT HOME: (248) 879-0835 … OR FAX HIM AT: (248) 879-6826

 

Date Reservation Received: ____________________________ Amount Received: ______________________ (__________ Days)

 

Membership Paid: ___________________________ New: __________________________ Renewal: _______________________