LE VIEUX PRESBYTERE- BOOKING FORM

The Property Address: Le Vieux Presbytère, Au Village, 32800 Noulens, France
The Property Owners: Richard & Jackie Wallace-Jones

NAME (HIRER) Mr/Mrs/Ms __________________________________________________

ADDRESS _________________________________________________________________

___________________________________________________________________________

_________________________________________ POST CODE _____________________

CONTACT TEL: _______________________ MOBILE ___________________________

EMAIL ADDRESS __________________________________________________________

Hire period: 1 / 2 week(s) Other (Please delete as appropriate)

Holiday start date: 16:00 Saturday the ________ day of _____________________

Holiday end date : 10:00 Saturday the ________ day of _____________________

I would like to reserve (please circle your choice) LA MOUETTE (6) - L'HERISSON (4)- BOTH
No of adults ______ No of children (please state ages) _______________________________

TOTAL RENTAL COST (*)

_______________________

Less 25% Deposit (enclosed)

_______________________

Sub Total

_______________________

Security Deposit (150 per gîte)

_______________________

BALANCE

_______________________

NB: Your deposit, required before a booking can be confirmed, is non-refundable.

You are advised to take out a Travel Insurance Policy with a cancellation clause that may enable you to recover non-refundable monies

I have read the document "Booking Terms and Conditions" and accept them on behalf of all my party who will reside in the property.

I further acknowledge that the balance (above), together with a separate security cheque, is due 6 weeks before the holiday start date on receipt of the final invoice from the Property Owners.

I enclose, with my completed Booking Form, my 25% Booking Deposit payment of _________ made payable to
Mrs J WALLACE-JONES -
or
I will be transfering my 25% Booking Deposit payment of _________ by electronic transfer or

I will be paying my 25% Booking Deposit payment of _________ by Paypal

(Please delete as appropriate)

WHERE DID YOU HEAR ABOUT US?

_______________________________________

Signed: _______________________________________

Date: _______________________________________