Venue Bali Lodge Company / Private Private Company Name Telephone Fax Email Contact Person Number of Adults (Male) Number of Adults (Female) Number of Children (under 12 years) Arrival Date   Arrival Time Departure Date   Departure Time Accommodation Required Yes No Accommodation Info Number of Single Rooms People sharing a room How many nights Do you require a Honeymoon Suite Yes No Do you need a Chapel? Yes No Do you need a Wedding Planner? Yes No Do you need a Chapel Yes No Special requirments