BOOKING FORM
PLEASE USE BLOCK CAPITALS
Please print this form and return it to: A Gorter, Grand Rue, 11410 Molleville, France.
Full Name: 
Address:


Home Tel:
Day Tel:
Fax:
Email:
Property required: the blue house / the storehouse / the artist's studio
No of weeks required:
Arrival date:
Departure date:
Number of Adults:
No of Children:
Names of other party members - please give ages of children


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

I enclose a non refundable deposit of  £ being 25% of the total holiday cost. I agree to pay the balance of £ plus a separate cheque for the damage deposit, which will only be cashed if damage has been done. (If booking within 8 weeks of the holiday start date the full amount should be enclosed.).

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

Signature:
Date: