Name and Surname*
Arrival dd/mm*
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
Octuber
November
December
Sex*
Select ------------>
Female
Male
Departure dd/mm*
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
Octuber
November
December
Country*
Select ------------>
Andorra
Argentina
Austria
Australia
Belgium
Bolivia
Brazil
Canada
Chile
Colombia
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
El Salvador
France
Germany
Greece
Guatemala
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
Israel
Italy
Jamaica
Japan
Luxembourg
Mexico
Netherlands
New Zealand
Nicaragua
Norway
Panama
Paraguay
Peru
Poland
Portugal
Puerto Rico
South Africa
Spain
Sweden
Switzerland
United Kingdom
United States
Uruguay
Venezuela
OTHER
Arrival Hour*
E-mail*
Type of Room
Select ------------>
Dormis without bath
Dormis w/ bath (shared)
Dormis w/ bath (ladies)
Dormis w/ bath (men)
Single
Double matrimonial
Double twin
Triple
Quadruples
Phone Number
Number of People*
Nationality
Comments
Age
Note:
• Dormis: Shared bedrooms with or without private bathroom.
•
Single, Double,
Triple & Quadruple: Private
bedrooms (all with bathroom).
(*) Obligatory
H. Yrigoyen 855 - Buenos Aires
0054 11 4342-2821 / 4342-8788
info@portaldelsurba.com.ar
amigos@portaldelsurba.com.ar
ESPAÑOL