Personal Information Request Form

Authorized Representatives for California Residents

* Indicates Required Field

Selection*

I affirm that I am an authorized representative of a California resident as defined by Section 17014 of Title 18 of the California Code of Regulations and am submitting this form on behalf of someone else.

Please complete on behalf of the California resident.

Guest Information

First Name*

Member Number

Enter your Loyalty number, if applicable

Last Name*

Address

Address Line 1*

Address Line 2

Zip / Postal Code*

State / Province / Region*

City*

Country / Region*

Contact

Phone Number*

Select Phone Type

Email Address*

Please provide the date and location of your most recent stay:

Arrival Date

Please use mm/dd/yyyy or dd/mm/yyyy

Departure Date

Please use mm/dd/yyyy or dd/mm/yyyy

Hotel Name

Hotel Location

Please select your request:

Select One*

Delete Personal Information

Change Personal Information*

Other*

*If selecting Change Personal Information or Other, please describe below

Other*

*If you have selected Change Personal Information or Other, please state your request

After receiving your request, we will contact you by e-mail with respect to the documentation and verification we require for submitting a request on behalf of someone else.

Personal Information Request Form

Authorized Representatives for California Residents

Please complete on behalf of the California resident.

Guest Information

Address

Contact

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