First Name: Last Name Phone Number Fax Number: E-mail: Address: Street Name / City / Province Postal Code / Country Type of Accommodation: Select OneSingle Room - $145Kitchenette - $185 Pets (add $10.00): Select OneYesNo Number of Nights: Arrival Date (mm/dd/yy): Select OneJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Remarks: Please note that upon confirmation of your reservation you will supply payment information. This form will not be used to transact any credit card information.

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Casa Loma Motel
Ph: (867) 633-2266 • Fax: (867) 668-4853
E-mail:[email protected]
1802 Centennial St. (Porter Creek)
Mile 921 Alaska Highway
Whitehorse, Yukon Y1A 3Z4