Booking Form


Please complete all details if you wish to confirm your booking of

423 Whittier Street, Bridgewater Crossing.

Please provide the following contact information:

Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

 Please enter names of all occupants in the box below:

            Enter the date of Arrival      -- dd/mm/yy


            Enter the date of Departure   -- dd/mm/yy

I agree to the booking terms and conditions

I enclose a booking deposit of ₤200 ( $360 US)

I agree to pay the balance  8 weeks prior to my vacation,

        plus a REFUNDABLE security deposit of  ₤200 ($360 US).

 

Signed                                                        Date

        Please print off and forward with payment by post as well as submitting electronically.


         

Author information goes here.
Copyright © 2003 [OrganizationName]. All rights reserved.
Revised: 06/02/08