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Newsletters - The Movement Disorder Society - MDS


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									2011 MDS International Congress Group Housing Request Form
Toronto, Ontario, Canada
 All group reservations must be received by the MDS Congress Housing Bureau by April 19, 2011. Reservations will be handled on a first-come, first-served basis. Complete all sections of this form
 before submitting. The MDS Congress housing bureau will not process any incomplete forms.

 Contact’s Last Name:                                                                     Contact’s First Name :                                                      Middle Initial:

 Company /Institution:


 City:                                                  State/Country:                                                           Zip/Postal Code:

 Email:                                                                            Tel:                                               Fax:

  Hotel Selections
  Indicate first and second choice hotel:

                  ____ The Fairmont Royal York                                                 ____ Intercontinental Toronto Centre
                       100 Front Street W, Toronto                                                  225 Front Street W, Toronto
                       $229 CAD + 13% tax                                                           $259 CAD + 13% tax

                   Tues      Wed         Thurs        Fri        Sat       Sun        Mon         Tues       Wed        Thurs         Fri       TOTAL
                   May       June        June        June       June       June       June        June       June       June         June       ROOM
                    31         1           2           3          4          5          6           7          8          9           10        NIGHTS
 Number of

  Reservation Guarantee

  Reservations will be handled on a first-come, first-served basis. To guarantee a hotel reservation, a non-refundable 50% payment of your total stay will be charged at the time of reservation.
  Payments can be made by credit card or wire transfer. Note that a 3% processing fee will be added to credit card transactions over $10,000 CAD. Rooms will not be guaranteed until pre-payment is
  received. Guests are responsible for payment of all additional charges at checkout. The rooming list deadline and the deadline for the remainder of the full payment for guaranteed room reservations
  is April 19, 2011. Any deposit and reservations made will be forfeited if full payment and rooming list are not received by this date. Requests for room reservations after this deadline can only be
  handled upon availability and with credit card guarantee.

 TOTAL PAYMENT AUTHORIZED: Room rate (including tax): ________________ X _______ total room nights reserved X 50% = _________________

  Payment Method (Choose one)

            VISA             Master Card             AMEX                Wire Transfer (please contact the housing bureau for more information)
                                                                    /         /
Card Number                                                   Expiration date

Billing Address

 Name of Cardholder (please print)                                                    Signature required, authorizing charge for cancellation and acknowledging Housing Policies

  Change of Hotel Bookings
  All changes to hotel reservations will be performed by the MDS Congress Housing Bureau. All changes must be requested in writing to MDS at MDSCongress@laser-registration.com

  Cancellation Terms and Conditions
  We regret that no refunds for cancellations can be made after the April 19, 2011 deadline; only name changes will be accepted after this date. Date changes will be handled on a
  case by case basis. Please contact the MDS Congress Housing Bureau (MDSCongress@laser-registration.com) in case of questions or alterations and cancellations.

                                                      FAX or EMAIL THIS COMPLETED AGREEMENT WITH DEPOSIT TO:
                                                                      MDS 2011 International Congress
                                                                          Fax: +1 514-380-5378
                                                                E-mail: MDSCongress@laser-registration.com

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