Jass Casino Tours
Reservation Form
* - Required field
Trip date* Hotel*
Accommodations: 1 Bed 2 Beds Smoking Non-Smoking Handicapped
Last Name* First Name/s*
Address* Apt./Suite
City* State* Zip Code* E-mail
Home Telephone* Work Telephone ext.
I/we will board the bus at: *Date of Birth
I / We will be sharing a room with:( Please fill out this portion if other than spouse)
Last Name First Name
Address Apt./Suite
City State Zip Code E-Mail
Home Telephone Work Telephone ext.
I/we will board the bus at: *Date of Birth
complete this form, print
and mail to:
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Price per person: # of people: Total amount: |
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