Hotel Details

VIP Hotel Reservation Form

Name *

First

Last

Title

Chapter or Lodge Name & No.

Jurisdiction (two letter State Name, e.g. "NJ")

Email *

Phone

Your Booking

Please Select the Type of Room For Your Stay

IMPORTANT NOTES: Only King Rooms Available.
1) The hotel will charge a one-night deposit at the time of booking your reservation. The deposit is refundable if your reservation is canceled at least 72 hours before your arrival date.
2) While we strive to accommodate your preferred room type, please note that requests are subject to availability and cannot be guaranteed.

Requested Dates

Date of Arrival *

Date of Departure *

Special Request:

Please let us know of any special requests/accommodation that you have regarding your room.

Credit Card Number: *

Please enter the credit card number you wish to use to secure your first night's stay at the Hyatt Regency.

Credit Card Expiration Date: (MM/YY)

World of Hyatt Rewards Number

If you have a World of Hyatt number you can enter it here to receive points for your stay.

First Night Hotel Reservation Charge Agreement: *

I Understand and Agree

By checking the box, I affirm that I understand and agree that that the hotel will charge a one-night deposit at the time of booking my reservation. The deposit is refundable if my reservation is cancelled at least 72 hours before my arrival date.