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Reservations Form


Please book using the reservation form if your meeting is at least 24hrs in advance; if not, please phone
 
** Cancellations & date/time changes made within 12hrs of your confirmed meeting will incur a $100 re-booking fee on top of any future meeting **
*Represents Mandatory field(s).
Select country : *
Full Name : *
Telephone Number : *
Email : *
Agency Atlantic Members Username :
Escort Name :
Location: *
  
Duration : *
Date of meeting: *
Time : *
City : *
Outcall address details :
Please supply landline telephone number, full address details & room number (if hotel):
Additional information :
Security code : *
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