Radiology International Inc.

  HOTEL REGISTRATION - BIARRITZ

Enclosed is our payment in the amount of $1,000 per room representing deposit for the Radiology Conference in Biarritz. Cancellations of land arrangements will result in a $100 per person administrative fee in addition to penalties that may be imposed by the hotel and ground operator. There will be no refund on cancellations received on or after August 24, 2008. By completing this form, we acknowledge and accept all the terms and conditions of the conference.

E-mail Address:

Full Name:

Additional Persons:

Address:

City, State/Province - Postal Code - Country

Home Telephone Number

Fax Number

Business Telephone Number

For questions please email Globe Travel Service (click here to email) or
call 800 942 4080.

Room Rates: 
   Physician Rate Single room $2,895   2nd person: $595.00
Rates Include Breakfast, Taxes and Transfers

NOTE: Prices may change if there is significant fluctuation in the exchange rates
.
Supplements for Seaview, Oceanfront Rooms, Junior Suites and Suites are available by contacting Sylvia, Claudia or Denise at Globe Travel. Contact details below.

 

If you have any special needs please note here.


A deposit of $1,000 per room is required. The balance is due August 24, 2008.

Payment Method

Card # or Check #


Exp. Date
 
                                                                                                                                               Authorized  Signature                                                           Security Code             
      

Total $ Enclosed

I am interested in information regarding:
Pre- and Post-Conference Tours    Air     Car Rental    

To pay by check or money order, please print and mail along with your check or money order made payable to:  

Globe Travel Service
225 North Main Street Suite 80
Bristol, CT USA 06010

 860-584-0517 or 1-800-942-4080 (Toll Free in the U.S.A.)
To pay by credit card, please print this form and mail or fax to:
Globe Travel Service, at the above address or fax to 860-585-6364.