NAME:_________________________________ COMPANY: John Jay 40th Reunion

ADDRESS:______________________________________________________________

WK PHONE:_________________________ HM PHONE:__________________________

( )Single (one king size bed)
( )Double (two double beds)
( )Non-Smoking  ( )Smoking

Name(s) of other(s) sharing room:________________________________________

Arrival Date & Time:_____________ Departure Date:________ # of Nights:___

- - - - - - - - - - - - - - Method of Payment - - - - - - - - - - - - - -
( )Please charge my credit card:

( )VISA  ( )MC  ( )AMEX  ( )Discover  ( )Diners Club  ( )Other:__________

Credit Card #:_____________________________ Expiration Date:_____________

Name on Credit Card: (please print)______________________________________

Cardholder's Signature:__________________________________________________

( )Other Method of Payment:
        Please specify and confirm directly with the Montauk Yacht Club
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If we receive your cancellation ten (10) days prior to your scheduled arrival date, your deposit will be refunded. However, a cancellation fee of $25.00 per room will be applied. If it is not received by that time, the total amount of your deposit will be forfeited. Any special request regarding location of rooms or bed type, has been noted, and it is based upon availability at the time of check in.