Palm Breeze Hotel
Pre-Registration Form
PALM BREEZE HOTEL Guest Pre-Registration, Liability Waiver & Safety Acknowledgement
Hotel Name: Palm Breeze Hotel
Address: 625 S Federal Hwy, Lake Worth Beach, FL 33460
1. GUEST & RESERVATION INFORMATION
Primary Guest Full Legal Name: ____________________________________
Date of Birth: ___________________
Government-Issued ID Type & Number: ___________________
Address: ____________________________________________________
Phone Number: ____________________
Email Address: ____________________
Check-In Date: ____________________
Check-Out Date: ____________________
Ours front desk hours are:
Sunday – Thursday
9:00 AM–12:30 PM
1:30 PM–6:00 PM
Friday – Saturday
9:00 AM–12:30 PM
1:30 PM–8:00 PM
Check-In Time: 3:00 PM Check-Out Time: 11:00 AM
– Early Check-In Requested ($25 – subject to availability) – Late Check-Out Requested ($50 – subject to availability)
Guest acknowledges early check-in and late check-out are not guaranteed and depend solely on availability. Call 48 hours prior to reservation date to check Availability.
2. OCCUPANCY, AGE & IDENTIFICATION ACKNOWLEDGEMENT Guest affirms they are at least 21 years of age and legally authorized to enter into this agreement. Guest agrees to present valid government-issued identification at check-in. Guest accepts full responsibility for all occupants, visitors, and minors associated with their reservation. Maximum occupancy limits must be observed at all times.
3. PAYMENT, TAXES & SECURITY DEPOSIT Guest authorizes Palm Breeze Hotel to collect applicable Florida sales tax and Palm Beach County tourist development taxes. A $100.00 security/property damage deposit is required per stay. Guest authorizes Palm Breeze Hotel to place a hold or charge on their payment method for: Property damage, Missing items, Policy violations, Normal wear and tear excepted.
4. PARKING ACKNOWLEDGEMENT Complimentary on-site parking is provided for registered guests only. A parking permit must be displayed at all times. Parking permits expire at check-out. Unauthorized vehicles may be towed at the owner’s expense. Palm Breeze Hotel is not responsible for theft, damage, or loss to vehicles or contents.
5. POOL & AMENITIES SAFETY ACKNOWLEDGEMENT Guest acknowledges that use of the swimming pool and hotel amenities is voluntary and at their own risk. Guest agrees that: No lifeguard is on duty. Children must be supervised at all times. Pool rules and posted signage must be obeyed. Slips, falls, drowning, and other injuries are inherent risks.
6. ASSUMPTION OF RISK & RELEASE OF LIABILITY To the fullest extent permitted by Florida law, Guest: Voluntarily assumes all risks associated with staying at Palm Breeze Hotel, including but not limited to: Slips, trips, and falls Pool-related incidents Parking lot incidents Food consumption Acts of other guests Environmental or weather-related conditions Guest releases, waives, and discharges Palm Breeze Hotel, its owners, employees, agents, and affiliates from any and all claims for personal injury, illness, death, or property damage except where caused by gross negligence or intentional misconduct.
7. HEALTH & COMMUNICABLE DISEASE ACKNOWLEDGEMENT (INCLUDING COVID-19) Guest understands: Exposure to communicable diseases, including COVID-19, is possible in public lodging settings. Palm Breeze Hotel cannot guarantee a disease-free environment. Guest voluntarily assumes this risk and agrees not to hold Palm Breeze Hotel liable for illness except as required by law.
8. INDEMNIFICATION AGREEMENT Guest agrees to defend, indemnify, and hold harmless Palm Breeze Hotel from any claims, damages, losses, or expenses arising from: Guest’s actions or omissions Actions of occupants or visitors Violation of hotel policies or laws
9. PHOTO, VIDEO & AUDIO RECORDING NOTICE & CONSENT (MANDATORY) Guest acknowledges and agrees that: Palm Breeze Hotel utilizes audio and video recording in public and common areas for safety, security, quality control, and training purposes. Guest consents to being recorded during their stay. Guest grants Palm Breeze Hotel the irrevocable right to use photos, video, and audio recordings containing their likeness or voice for reasonable marketing, promotional, and training purposes, without compensation. This consent is mandatory and a condition of stay.
10. PRIVACY & DATA USE Guest authorizes Palm Breeze Hotel to collect and store personal information for: Reservation management Payment processing Legal compliance Safety and security Information will not be sold and will be handled in accordance with applicable privacy laws.
11. SEVERABILITY & GOVERNING LAW If any provision is deemed unenforceable, the remaining provisions remain in full effect. This agreement is governed by the laws of the State of Florida. Venue for any dispute shall lie in Palm Beach County, Florida, unless otherwise required by law.
12. CLEANING & SMOKING FEE If the room is found to be dirty, debris left, etc., beyond normal standards and/or if Guest has/had been smoking in the room a $250.00 fee will be charged. Up to $500 for both excessive cleaning & smoking fee.
13. INCIDENTALS Guest(s) agree that any additional incidentals caused by Guest(s), and their Guest(s)/Visitor(s) will be charged to Guest(s) card on file. Guest(s) agree that their credit card information, including the CVV/CVV2 will be stored so that the Hotel may charge them for any incidentals. Palm Breeze Hotel will perform an inspection within 15 days of their check-out and has the right to charge the Guest(s) within 30 business days of their check-out date and time. Guest(s) acknowledge this provision during booking & check-in and understand their card will be charged without further notice. It is the responsibility of the Guest(s) to contact Palm Breeze Hotel for a breakdown on the charges.
14. ACKNOWLEDGEMENT & SIGNATURE By signing below, Guest acknowledges that they have read, understood, and voluntarily agreed to all terms of this agreement.