Name:
Address:
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Postcode:
Telephone:
Mobile Telephone:
E-mail:
Date of Arrival:
Date of Departure:
No. of Nights:
Arrival Travel Details:
Departure Travel Details:
How did you hear about the villa?
I hereby agree to be bound by the booking conditions
Signature: Date:
(Monies received acknowledges and accepts Booking Conditions)
Tariff for Holiday £…………
Security Deposit £ 250.00
Buggy Hire £ …………
Amount Due: EITHER: If less than 8 weeks to arrival, Full Amount: £ …………
OR: If more than 8 weeks to arrival, 30% Deposit: £…………
Payment now due £
I enclose my cheque payable to ‘Mr M Le Clercq’ for the required amount:
OFFICE USE Booking Ref: ……………….
Confirmation of the above booking: ………………………………
Balance: £…………………………….. Cheque payable to: ‘Mr M Le Clercq’
Please return this slip with payment before: ……………………….
To: Mr M Le Clercq, Cleveland, Pound Street, Lyme Regis, Dorset. DT7 3JA