Martha Tilaar Salon & Spa Bali -

RESERVATION FORM

	Full Name Treatment



	Full Name Treatment



	Full Name Treatment




	Email Address :
	Nationality
	Date Time :
	Pick Up Service Yes No
	Arrival Date in Bali
	Name of Hotel

Payment Methode Cash Credit Card

For Credit Card Payment, your reservation request can only be processed once we receive your credit card details. You may either include these details on this form or, if you prefer to send them by fax, you should submit this Internet / email reservation form first (without your credit details) and then fax to (62-361) 777664 the credit card details using this form within 24 hours. Please only use the fax form provided by printing the credit card section of this form.

Please indicate that Martha Tilaar Salon & Spa will guarantee only reservation with full payment. Any changes of time is possible based on availability. 50% cancellation fee will be borne from the total amount for any cancellation of reservation.

Guest with cash payment would be reconfirmed by our Guest Service Agent a day before your appointment schedule.