HOTEL RESERVATION FORM
15th ASIA PACIFIC ENVIRONMENTAL & OCCUPATIONAL DERMATOLOGY SYMPOSIUM
44TH ANNUAL DERMATOLOGY CONFERENCE (ADC) OF DERMATOLOGICAL SOCIETY OF MALAYSIA (DSM)
12TH – 15TH SEPTEMBER 2019
EMAIL TO: reservations@royalechulan-kualalumpur.com or resv.trc@royalechulan-kualalumpur.com
wazwani.sales@royalechulan-kualalumpur.com cc: batrisha.sales@royalechulan-kualalumpur.com

HOTEL RESERVATION DEADLINE: 3rd SEPTEMBER 2019

Registrant’s name ____________________________________________________________________________________________
SurnameFirst Name
Sharer’s name _______________________________________________________________________________________________
SurnameFirst Name
Title_________________________________________

Company___________________________________________

Business address _____________________________________________________________________________________________

Street address or P O Box #______________________________________________________________________________________________

City/Town

State

Telephone : ____________________________Facsimile : __________________________Email : ___________________________

Arrival date______________________ Limousine Pick-Up at RM320nett per car (Y / N) FLT # / Time: ________________________

Departure date___________________ Limousine Transfer at RM320nett per car (Y / N) FLT # / Time : ________________________

Superior Single
Superior Twin/Double

RM350.00nett per room per night inclusive of daily breakfast for one (1) person
RM390.00nett per room per night inclusive of daily breakfast for two (2) person

Deluxe Single
Deluxe Twin/Double

RM390.00nett per room per night inclusive of daily breakfast for one (1) person
RM430.00nett per room per night inclusive of daily breakfast for two (2) persons

Premier Single
Premier Twin/Double

RM430.00nett per room per night inclusive of daily breakfast for one (1) person
RM470.00nett per room per night inclusive of daily breakfast for two (2) persons

Royale Club

RM570.00nett per room per night inclusive Club Floor benefits for two (2) persons

Executive Suite

RM720.00nett per room per night inclusive Club Floor benefits for two (2) persons

Premier Suite

RM970.00nett per room per night inclusive Club Floor benefits for two (2) persons

Room PreferenceSingle
Smoking

Dietary Preferences________________________________••

DoubleNon-SmokingAllergies___________________________________________

Please be informed the hotel is not holding any accommodation outlined above
Any reservation received will be subject to availability at hotel prevailing rate

I hereby authorize The Royale Chulan Kuala Lumpur to charge ___________________ to my credit card details as follows:

Credit Card Type:VisaMasterAmex

JCBDiners (please circle)

For Amex, please provide 4 digits I/D No ____________________For VISA / MASTERCARD, please provide 3 digits (behind credit card) I/D No ______________
Credit Card No: _____________________________________

Expiry Date_____________________•Reservation must be guaranteed with credit card otherwise is deemed not confirm and will be released 7 days prior to arrival•CANCELLATION POLICY : 100% cancellation charges throughout the stay will be applicable for “No Show” or cancellation made 14
days prior to arrival date

I agree to the following Terms & Conditions•
Rates quoted in Ringgit Malaysia and subject to 6% SST•
Room type is subject to availability•
Additional breakfast is chargeable at RM 40.00 Nett per person•
Extra bed is chargeable at RM 190.00 Nett per unit per day inclusive of one (1) breakfast – subject to availability•
Limited number of rooms available per category. Once a category has been sold, the next available category will beoffered. Confirmation is subject to room availability.
•Cancelation received within 14 days prior to arrival, cancellation fee equivalent to the value of the entire stay will be levied upon.
•In the event of ‘no-show’ a cancellation fee equivalent to the value of entire stay will be levied upon.
•
Check in time is after 3pm and check out at 12pm. Early check in or late check-out arrangements can be made at applicablecharges and subject to availability•
Credit card details provided will authorize hotel to charge the necessary payment related to this reservation•
Airport transfer rate is for Limousine to/from KLIA and subject to 50% surcharge for usage between 00:00 – 06:00 hrs•Bookings will be made upon receiving full details via reservation form with credit card details for guarantee purposes•Rates are subject to changes after the above stated cut-off date
Notification of Tourism Tax Act 2017 (Act 791) passed in accordance of Laws of Malaysia on 19 June 2017, with reference to Part III of theAct that imposes a tax known as Tourism Tax on tourists staying at any accommodation premises. In accordance to the said law, it shall be
the duty of the tourist to pay the Tax to the hotel.
Imposition of the Tourism Tax is set to commence on 1 September 2017 (P.U.(B) 398 – Appointment of Date Coming into Operation), at a
rate of Ringgit Malaysia Ten only (RM10.00) per room per night or any part of (P.U. (A) 241 – Tourism Tax (Rate of Tax) Order 2017)

GUEST’S SIGNATURE
Name : _____________________________________________FOR HOTEL USE
Confirmation No : ______________________________________

Date : _____________________________________________

Date Confirmed : _______________________________________

Reservation Department
ROYALE CHULAN KUALA LUMPUR
Group Booking: resv.trc@royalechulan-kualalumpur.com: reservations@royalechulan-kualalumpur.com

Office Phone: 03 2688 9688