Name:
Address:
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Postcode .Phone No . E.Mail..................................
Rental Period Required: From ...... To: ..............
Names of Accompanying Party:
Surname First Name Age if Under 21
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Any special requirements? ..
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I have read and accept the enclosed booking Terms and Conditions on behalf of myself and all the other members of my party.
I confirm that I am over 21 years of age.
Signed Date .
I enclose a cheque payable to R.Harrison for £ .
In respect of:(delete as necessary)
Booking Deposit(To Confirm)£ .
Full payment if booking within 8 weeks of departure £
Extra Requirements £
We also accept Credit Cards. Card No
Expiry Date . Name on Card ..
Or phone details.
Payments should be addressed to:
Mr.R.Harrison
73 Old Rd
Ashton U Lyne
Lancs
OL69DH
Telephone 01613442650 Fax 01613394292