Arisia '04 Hotel Registration Form

(Get a PDF version of this form.)

Print this form and mail it to: Reservations Boston Park Plaza Hotel 64 Arlington Street Boston, MA 02116

Fax to: 617-423-1708

ALL REQUESTS MUST BE RECEIVED BY 4PM ON JANUARY 9, 2004
Please read all hotel information before filling out this form.

Name _______________________________________________________________________

Sharing with (List all occupants) __________________________________________________

Arrival date (if different for shares) _____________________________________________

Address ____________________________________________________________________

City __________________________________ State ______ Zip ___________________

Phone _______________________ Email ________________________________________

Credit Card # _____________________________________________ Expiration __________

__ AmEx    __ Visa    __ MasterCard    __ Discover    __ Diners Club

Signature __________________________________________________________________

Arrival Date ________________ Time ________________ (Check-in is after 4PM)

Departure Date ________________ Time ________________ (Check-out is before 12:00 Noon)

Room Type (This is only a request, not a guarantee) '1' for first choice, '2' for second choice:
__ Main Single - $79    __ Main Queen - $99    __ Main King - $119    __ Main Double - $119  
__ Executive King; - $139   __ Handicapped King - $139    __ Family Double - $139   
__ Junior Suite - $139    __ 1-BR Suite - $225    __ 2-BR Suite - $295

__ Request cot (limit 2 per room, no cots in Main Single or Main Double)
__ Request crib
If request of Double is not available, please add a cot to my room: __ yes   __ no

Arisia Block (pick one)
__ Quiet    __ Party    __ Party Host    __ Shabbat    __ Smoking    __ Staff

By requesting a reservation attendee agrees to conditions and limitations listed in Hotel Reservation Policies.