2017 KMEA Group Housing Form

Galt House Hotel

140 N. Fourth Street

Louisville, KY 40202

Phone 502.589.5200 • Fax 502.585.9029

Attn: Mary Drury ()

Please PRINT or TYPE to assure accuracy.

•DEADLINE: January 7, 2017

•All confirmations will be sent to the individual listed below.

•Cancellation Policy 48 hours prior to arrival.

Please check the housing type below: Forms will not be accepted unless housing type is noted.

Kentucky Children’s Chorus / KMEA policy requires the parent or legal guardian and the teacher for every student attending.
Kentucky Junior High Chorus / KMEA policy requires a minimum of one chaperone and the teacher for every three students attending.
All-State High School / KMEA Policy requires teachers to seek housing in the same hotel as their students.
Other (describe to the right)

()

Director First NameLast NameArea CodePhone Number

()

School NameArea CodePhone Number

School AddressCityStateZip Code

Email

Reservation List

Arrival Departure

Room 1 / Student / Chaperone / Director / List school if sharing housing
1
2
3
4

Arrival Departure

Room 2 / Student / Chaperone / Director / List school if sharing housing
1
2
3
4

Arrival Departure

Room 2 / Student / Chaperone / Director / List school if sharing housing
1
2
3
4

Arrival Departure

Room 4 / Student / Chaperone / Director / List school if sharing housing
1
2
3
4

Arrival Departure

Room 5 / Student / Chaperone / Director / List school if sharing housing
1
2
3
4

*Rooms may not be available for check-in until 3:00 PM. Check out time is 11:00 am.Failure to cancel at least 48 hours prior to arrival of the reservation will result in one night’s room charge.

KMEA requires the signature of the school principal on any housing form that includes a teacher or adult chaperone assigned to the same room as students.

Principal Signature

2017KMEA Room Rates:

(Overnight self-parking is $10.00 per day)

Galt House STATE SALES TAX EXEMPT RATE per night, which includes 9.5% tax

Occupancy / Full-Rate / Per Person
1 Person / $145.64 / 145.64
2 Persons / $151.11 / $75.56
3 Persons / $156.59 / $52.20
4 Persons / $162.06 / $40.52

Galt House NON-EXEMPT RATE per night, which includes 16.07% tax

Occupancy / Full-Rate / Per Person
1 Person / $154.37 / 154.37
2 Persons / $160.18 / $80.09
3 Persons / $165.98 / $55.33
4 Persons / $171.78 / $42.95

To confirm reservations we require a guarantee by major credit card, purchase order or a check for one night’s deposit. Invoices can be provided upon request.

Check# and Amount Purchase Order# and instructions

(Check deposits must be received in advance)(Copies of Purchase Orders must be submitted to the Galt House)

Charge Card Name:

Charge Card #:Expiration Date: