Haunted Sights and Historic Nights Overnight Hotel Package Booking Form

Please complete and fax, or email this form to us.

*Check in Date: __________________ Check out Date: ______________________

Occupancy: _____ Single _____ Double

*Tour Name: _____________________________ *Tour Date: __________________________

*Subject to availability

Guest's Name(s): _______________________________________________________________

Street Address: ________________________________________________________________

City: _____________________ State/Prov.: _________ Zip/Postal Code: ___________________

Phone Number: ____________________________ Cell/Bus Phone: ________________________

Email: _____________________________________________________________

Please charge my payments to:  (Circle)        Visa   or   MasterCard

Account Number: _______________________________________ Expiry Date: _____/____

Signature: __________________________________________________ Date: ______________

Additional Notes/Requests: _________________________________________________________

______________________________________________________________________________

Send completed booking form to:

Heartland International Travel & Tours

Suite 202-3111 Portage Avenue

Winnipeg, MB  R3K 0W4

Fax: (204) 989-9636  Phone: (204) 989-9630  Toll Free: 1-866-890-3377

Email: info@heartlandtravel.ca

Upon receiving this completed booking form, we will contact you with confirmation, tour and payment information