2016 Speaker - Saint Barth Dental

Registration 2016
Doctor’s Name: ______________________________________________________________________
Accompanied By: _____________________________________________________________________
Street Address: ______________________________________________________________________
City: ___________________________________State: _________
Zip::________________
Telephone (Office): _____________________________ (Home): ________________________________
Fax: __________________________________ Email Address: _________________________________
Arrival Date: ____________________________ Departure Date: __________________________
Please fill out one:
Hotel Selected: ______________________________Or, Villa Selected:_____________ Agency:_________
!
Please complete all forms and send a $1500 check for the Conference Registration Fee to our NJ address on
the homepage. The fee includes our Sunday night Welcome Cocktail Party, Tuesday evening event and
Thursday night dinner and entertainment + other amenities. We will book your hotel room as selected or your villa
choice. If you have already booked a villa, please indicate it at the bottom of page 2. Upon receipt of your
registration, you will receive a confirmation from us. You will also be contacted either by your hotel or the villa agency.
Payment to the hotels will be in Euros and payment for the villa rental will be in US dollars. Please see your selected hotel’s
web site for details, tax info, cancellation and change policies.
!
The hotel rates below include a room for two and breakfast where indicated. Most registrants arrive earlier or extend after
the meeting dates. If you would like to arrive earlier or extend, please inform us as soon as possible. Hotel rooms of this class
are at a premium during the season.
!
The SBDA earns commissions from each hotel, villa and car reservation we make and these commissions
help fund the cost of organizing the conference and keep the registration fee low. If you reserve
accommodations or a car directly, use a villa agency other than one of the five we recommend, or reserve
through a travel agent you will be charged a $1900 event registration fee.
!
Check our web site (www.saintbarthdental.com) for additional information regarding transportation, island and program
information. Please don't hesitate to contact us at 201-436-0869 for hotel, villa rental, car or air information.
2016 Speaker
Michael Moscovitch DDS, Prosthodontist
Patient Specific Restorations: the Reality of High Performance Ceramics in the
Treatment of Tooth and Implant Supported Cases
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Hotels or Villa
Please see the hotel/villa site for cancellation policy, tax/fee info and other inclusions.
Select
Breakfast
Hotel
Accommodation
Daily Rate
"
Y
Christopher
Ocean Classic
€ 490.50
"
Y
Christopher
Ocean Terrace
€ 580.50
"
Y
Christopher
Ocean Junior Suite
€ 670.50
"
Y
Christopher
Ocean Deluxe Terrace
€ 801
"
Y
Christopher
Ocean Balcony Junior Suite
€ 846
"
Y
Christopher
Ocean Suite
€ 1278
"
Y
Christopher
Aloes Jacuzzi Suite
€ 1417.50
"
Y
Christopher
Ocean Panoramic Suite
€ 1575
"
Emeraude Plage
Bungalow C – Garden View
€ 445
"
Emeraude Plage
Bungalow B – Beachside Garden
€ 475
"
Emeraude Plage
Bungalow A – Beachside
€ 545
"
Emeraude Plage
Cottages - Ocean Front
€ 850
"
Emeraude Plage
Stone House – Garden View 3BR
€ 1,250
"
Emeraude Plage
Bungalow E – Deluxe Ocean View
€ 890
"
Emeraude Plage
Bungalow D16–Deluxe OceanFront
€ 985
"
Emeraude Plage
D15–Deluxe Ocean Front
Private Jacuzzi
€ 1,450
"
Emeraude Plage
Bungalow F – Deluxe Ocean View
2BR
€ 1,250
"
Emeraude Plage
Villa Emeraude – Deluxe Ocean
Front 2BR Private Jacuzzi
€ 2,250
"
Emeraude Plage
Villa Emeraude – Deluxe Ocean Front
3BR Private Jacuzzi
€ 2,750
"
Y
Les Ondines
1 Bedroom Suite - Pool-Garden
View
€ 425*
"
Y
Les Ondines
1 Bedroom Suite - Beachfront
€ 550*
"
Y
Les Ondines
2 Bedroom Suite - Beachfront
€ 850*
"
Y
Les Ilets de la Plage
Beach Villa – 1 Bedroom BOOKED
€575
"
Y
Les Ilets de la Plage
Garden Villa – 1 Bedroom
€465
"
Y
Les Ilets de la Plage
Garden Villa – 2 Bedrooms
€700
"
Y
Les Ilets de la Plage
Garden Villa – 3 Bedrooms
€730
"
Y
Normandie Hotel
Queen Bed Room – Single
Occupancy
€180
"
Y
Normandie Hotel
Queen Bed Room – Double
Occupancy
€215
*Les Ondines rate includes 5% tax
Villa Request
Villa "
Agency:
Villa Name:
Weekly Fee
2
VAuto Request
Driver Name #1: ______________________________________________________________________
Driver Name #2: ______________________________________________________________________
Driver License Number #1: _______________________State::______
Driver License Number #2: _______________________State:______
Driver’s Mailing Address:
Car Requested:
or
_______________________________________________________________
_____________________________________________________________________
_________________________________________Exp :____/____
____________________________________________________Exp :____/____
Name on Credit Card: ____________________________________________________________________
Check with your insurance company and credit card companies to determine if you must insure your rental car
All vehicles are automatic and air-conditioned. Please choose carefully, as it will be difficult to change vehicles upon arrival.
Car Type:
" $58/day Hyundai i10
" $78/day Daihatsu Terios
" $98/day Jeep Wrangler Convertible
" $108/day Mini-Cooper Convertible
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