Dockside Resort 403 East Shore Drive
Clearwater Beach, FL 34630
727-443-6665

(If you are going to print this form only 
what you see will print).
Reservation Request Form

Please enter your Name:
Company:
Address 1:
Address 2:
City: 
Including Surrounding Region (U.S. Only)
Zip:                       Country: 
Phone:  Fax: 
E-Mail:
Type of Unit Desired: 
Arrival Date:
Departure Date:
Number of Adults:
Number of Children:        Ages: Ages: 

There are 4 ways to reserve your room with a 50% deposit. If the room is not available on the dates you requested, your credit card will not be charged.

  1. You can fill out the credit card information required below and hit the "submit" button.
  2. You can fax this form with your credit card information.
  3. You can call us with your credit card information
  4. You can mail this form with your Check or credit card information. 
Please enter type of Credit Card: 
Discover   VISA Master Card
Credit Card Number:    Expiration: 
Name on Credit Card: 
Please enter any comments or special needs below,

To submit your information, press 
Thank You.
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