Booking Form

Le Pigeonnier / La Loge / La Petite Maison*

Name: ........................................................................ (Block Capitals please)

Address: .........................................................................................................................

.........................................................................................................................

Telephone No.: (Home) ...................................... (Daytime) ............................................

Email Address: .......................................................................................................................

I wish to book the above property from .................................................................................

to ........................................................................ (Departure Date).

Price per week: 1st Week ..............

2nd Week ..............

3rd Week .............. Total Rental .............

Names of other party members: Age if under 18

................................................................................. ......

I require linen to be provided for .......... (number of people).

I enclose my cheque for the Deposit, being 25% of the total cost £ .................

I declare that this booking is made in accordance with the associated terms and conditions and

accept them on behalf of all members of my party, on whose behalf I am duly authorised to make

this agreement. I agree to be held responsible for all fees payable and I am over 18 years of age.

Date: ........................................ Signed: ...................................................................

We should be grateful if you could tell us where you saw our advertisement :

...............................................................................................................................................

Please complete and return one copy of the Booking Form to Jackie and Roger Lane at the

above address within 7 days of your telephone reservation. Cheques should be made payable to

R D and J M Lane.

BOOKING FORM