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Data19.06.2016
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H O T E L B O O K I N G F O R M

Non-refundable reservation
Please fill out the form in capital letters and return together with the scan of both side of credit card or bank transfer copy to:
OST GROMADA, Gromada Hotel, ul. 17 Stycznia 32, 02-148 Warszawa
phone:. +48 22 576 45 00/ 00 48 502 456 434, fax. +48 22 846 15 80, e-mail: salsalibrefestival2014@gromada.pl

(Please fill in capital letters) MR □ MRS




DETAILS GUEST: DETAILS ACCOMPANYING :
SURNAME : SURNAME:

NAME: NAME:

PHONE: PHONE:

ADRESS: ADRESS:

DATE BIRTHDAY: DATE BIRTHDAY:

PASSPORT NUMBER : PASSPORT NUMBER:





DETAILS ACCOMPANYING:
SURNAME: SURNAME:

NAME: NAME:

PHONE: PHONE:

ADRESS: ADRESS:

DATE BIRTHDAY : DATE BIRTHDAY:

PASSPORT NUMBER : PASSPORT NUMBER :




H O T E L R E S E R V A T I O N


Arrival date __________________ Departure date __________________ nights _______ Number of People _______



Hotel Rooms* ECONOMY STANDARD BUSINESS

SGL (SINGLE) □ _____ PLN □ ____ PLN □ ____PLN
TWIN (2 beds) □ _____ PLN □ ____ PLN □ ____ PLN
DBL (DOUBLE) □ ____/____ PLN

(Depending on the number of guests)

AP (A SUITE) □ ____ PLN □ ____ PLN □ ____ PLN



* check-in starts at 14.00 on arrival, and ends at 12.00 the day of departure Prices include breakfast, free Wi-Fi and VAT

** prices are per room per night. We do not sell individual beds in Twin Rooms


TOTAL AMOUNT:________PLN




Non-refundable policy of reservation:

- Please remember it will be full pre-payment for total stay – we do not give the payment back.

- Please fill out the form, remember to choose the Payment method and send it back to us. These are conditions to get a confirmation of booking.

- We do not accept Cancellation, Modifications of the Reservations.

- We do not return the payment in situation of NO SHOW.


Please choose the Payment method:

Bank Transfer to: Hotel Gromada ul. 17 Stycznia 32, 02-148 Warszawa, BRE BANK SA

IBAN: PL95114010100000514114001039 SWIFT CODE: BREXPLPWWA1 (pay in PLN)

□ Hotel Gromada ul. 17 Stycznia 32, 02-148 Warszawa, BRE BANK SA

IBAN: PL81114010100000514114001097 SWIFT CODE: BREXPLPWWA1 (pay in EURO)



Postscript: Reservation for: ______________________________________________________________________ (name, surname)

* Reservation guaranteed

** Send back the bank transfer copy as soon as possible

I authorize OST Gromada to charge my credit card: □ Visa □ Master Card □ American Express □ Diners

The card number ____________________________________________________ Expiry Date _____________________________________



The name of the cardholder _____________________________________________ Signature _________________________________________
Amount to pay _______________________________________________________ Date ____________________________________________

* Reservation guaranteed


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