La Fontaine Guest Cottage
Booking form
Place the cursor in the booking form field, then click the right mousebutton and choose for print
Please send to: Robert Schrik / Wim Clifford, Manoir de la Fontaine - Le Terme de Lafont
24500 St.Capraise d´Eymet - Dordogne - France

Full Name:

Address:

Home Tel:

Day Tel:

Fax:

Email:

No of weeks required:

Arrival date:

Departure date:

Name of other party member

I am authorised to make this booking on behalf of my party. I am over 18 years of age.

I have read and accept the Terms and Conditions of La Fontaine Guest Cottage and transfer my
non-refundable deposit of Euro _______ being 25% of the total rent due to the account of:

Robert Schrik / William Clifford
Bank: ABN/AMRO - Apollolaan - Amsterdam
IBAN: NL11 ABNA 0460 873067
SWIFT: ABNANL2A

I agree to pay the balance of Euro _______ plus a returnable security deposit of Euro 250, 8 weeks before the start of the rental period. (If booking within 8 weeks of the start of the rental period the full payment should be transfered.)

Note: It is advisable to arrange insurance against cancellation of your holiday.

Signature:

Date:

( PLEASE USE BLOCK CAPITALS)

Manoir de la Fontaine, Le Terme de Lafont
24500 St.Capraise d´Eymet
Dordogne, France

*La Fontaine Guest Cottage* Booking form Place the cursor in the booking form field, then click the right mousebutton and choose for print Please send to: Robert Schrik / Wim Clifford, Manoir de la Fontaine - Le Terme de Lafont 24500 St.Capraise d´Eymet - Dordogne - France
Full Name:
Address:
Home Tel:	Day Tel:
Fax:	Email:
No of weeks required:	Arrival date:	Departure date:
Name of other party member
I am authorised to make this booking on behalf of my party. I am over 18 years of age. I have read and accept the Terms and Conditions of La Fontaine Guest Cottage and transfer my non-refundable deposit of Euro _______ being 25% of the total rent due to the account of: Robert Schrik / William Clifford Bank: ABN/AMRO - Apollolaan - Amsterdam IBAN: NL11 ABNA 0460 873067 SWIFT: ABNANL2A I agree to pay the balance of Euro _______ plus a returnable security deposit of Euro 250, 8 weeks before the start of the rental period. (If booking within 8 weeks of the start of the rental period the full payment should be transfered.) Note: It is advisable to arrange insurance against cancellation of your holiday.
Signature:	Date:
( PLEASE USE BLOCK CAPITALS)