Rental Booking Form

Please telephone 01384 562986 to confirm your booking, then complete, sign and return this booking form including your £150 per week deposit to :-
Mr & Mrs P.Jones, 16 Church Street, Quarry Bank, Brierley Hill, West Midlands, DY5 2JL

Name
  
Address Line 1
  
Address Line 2
  
Address Line 3
  
Post code
  
Telephone
  
E-Mail
  

Villa Requirements

Number of Guests
Number of Adults
Number of Children
     

 

Number of Weeks Arrival Date Departure Date Weekly Rate
--Total--
         
Pool heating required? Yes/No £85.00  
Total Cost of Villa Rental
  
Less Booking Deposit @ £150 per week
  
Plus Security Deposit @ £200 per week (£400 max)
 
Balance Payable 8 weeks before arrival at the villa (inc security deposit)
  

I confirm that I would like to book your luxury villa and have enclosed my booking deposit with this form. I agree on behalf of all the persons in my party to accept the booking terms and conditions and am over 21 years of age.

Please note, this declaration must be signed to validate the agreed terms and conditions and confirm your booking. Thank you.

Print Name :
  
Signed :
  
Date :
  

FOR OFFICE USE ONLY
Date deposit received   Receipt letter sent on  
Balance due date   Amount Due  
Receipt letter, maps & door code e.t.c sent date