Contact Name:

email:

Tel:

Mobile:

Address:

Period:  ___________               (date)

(arriving after 3pm)

To:        ___________               (date)

(leaving by 10am)

Nights:       ______

Persons in your Party:

Name                                   Age if under 18

1. ______________________    ________

2. ______________________    ________

3. ______________________    ________

4. ______________________    ________

5. ______________________    ________

Car Parking:-

Is car parking required? (this is off road parking within 20 yds of the property)

Yes / No  -  Car Registration No:- 

_____________________________

NB - There is space for one car only

Towels:-

Do you require towels at an additional cost of £5 per person per week

Yes / No

I declare that I am over the age of 18 years and hereby accept on behalf of myself and all persons in my party that this booking is made in accordance with the accompanying terms and conditions and to make all payments in relation to these.

Signed:

Date:

PLEASE INDICATE HOW YOU FOUND SMITHY’S COTTAGE ON THE INTERNET or WHICH ADVERTISEMENT:-  

Return this completed booking form with £50 per week (or part week) deposit. A 2 week booking requires a deposit of £100. (if booking is within 1 month full payment is required please)  

Please make cheques payable to Pam Livesley and post this form & cheque to:- 

Pam Livesley, 136 Hillside Road, Bramcote, Nottingham, NG9 3BD