To: James / Super 8 Motel
Fax Number: 702-794-3504

FAX RESERVATION SHEET
FOR HIGH ROLLERS WEEKEND

Please reserve a room for:

Full Name ___________________________________________

Address ____________________________________________________

City _______________________________________

State, Providence, or Country ____________________________

Zip or Postal Code ___________________________

Guest Arrival Date: February ________, 2008

Guest Departure Date (morning departure): February ________, 2008

SMOKING (YES or NO)__________________

1 or 2 QUEEN BEDS (1 or 2) ________________

DISCOUNT CODE: HIGH ROLLERS

Credit Card Number ____________________________________

Exp date ____/____

Name on card if different than above __________________________

Address of cardholder if different than above _______________________________________

Email address or fax number* for hotel to send a reservation confirmation to:
_____________________________________

*(please include country code for out of country fax numbers)