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| 1.
PERSONAL DETAILS |
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First
Name |
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Last Name |
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Address 1 |
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Address 2 |
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Town/ City |
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County |
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Post
Code |
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Home
Phone No |
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E-Mail
Address |
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Number in Party |
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Where did you here about us |
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2. HOLIDAY DETAILS |
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House
to rent: La Maison |
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Rental
Period |
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| 3.
PAYMENT DETAILS |
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Rental
Cost (in Euros) |
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Bed
linen/ towels/ etc (optional) €26 double bed or €13 single (Please insert total cost ) |
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I need |
single
double |
Heating
(Compulsory 16th Oct-16th April)
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Welcome
Pack (optional)
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Total
to Pay |
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Minus
the Booking Deposit* of €110 per week |
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Remaining
Balance** |
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| CREDIT/ DEBIT
CARD DETAILS |
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Visa
or Mastercard Number |
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Last
three digits on strip on back of the card |
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Expiry
Date |
month
year |
CARDBOOKING DECLARATION
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IMPORTANT
By
pressing the 'Submit form' button below I confirm that I have
read and agree to be bound by all of the Terms and Conditions
of rental.
To
view the Terms and Conditions of rental then please CLICK
HERE
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