Team Entry Form

Reservation Form Fern Valley Hotel and Convention Center – Louisville, KY (877) 564-3311 For on-line reservations, go to: https://reservations.ihotelier.com/crs/g_reservation.cfm?groupID=415996&hotelID=15455 National 4-H Livestock Judging Contest North American International Livestock Exposition November 13-17, 2010 (Please type or print information on this form)

Please complete the following information for your reservation:

Name(s) of additional person(s) sharing room:

Address:

Phone: Fax:

Arrival Date: Departure Date:

No. of Rooms: Room/type Requested:

Smoking Request: Please note:  Check-in is at 3 pm (late check-in is after 6 pm – must notify hotel)  Check-out is at noon  72 hour advance cancellation required  Room reservation cutoff date is OCTOBER 22, 2010  Room rate is $87 + taxes (up to 5 persons per room ($100.06 including taxes)  A deposit of 1 night’s rate is required with your reservation request. Accepted methods of payment include American Express, Diners Club, Visa, Discover Card, Master Card, Carte Blanche, or Check (with ID)

For all credit card payments, complete the following:

Card Type: Expiration Date:

Card Number:

Name on Card:

Authorizing Signature:

Fax this form to: (502) 966-4874 or Mail this form to: Reservations Fern Valley Hotel and Convention Center 2715 Fern Valley Road Louisville, KY 40213