Lead Name of Party: *


Full Postal Address: *


Contact Telephone Number: *


Email Address: *


Name of Party Members (& age if under 18): *


Accomodation Required (select relevant gite): *
Le Vieux Café
Ecurie
Both

Start Date of Holiday (Week starts on a Saturday): *


Number of Nights/Weeks Required: *
3 Nights 4 Nights 5 Nights 6 Nights 1 Week 2 Weeks 3 Weeks 4 Weeks

Cot Required?
No
Yes

Extra Services Required (If Yes please tick from the options below): *
No Yes

Welcome Pack of Supplies:
No Yes

Babysitting Service Qty:
None 1 Night 2 Nights 3 Nights 4 Nights 5 Nights 6 Nights 7 Nights

Arrival Meal Prepared Qty:
None 1 Person 2 People 3 People 4 People 5 People 6 People 7 People 8 People 9 People 10 People

Sunday Barbeque Qty:
None 1 Person 2 People 3 People 4 People 5 People 6 People 7 People 8 People 9 People 10 People

Departure Breakfast Qty:
None 1 Person 2 People 3 People 4 People 5 People 6 People 7 People 8 People 9 People 10 People

Payment Currency: *
Pounds Sterling
Euros

Total Rental Cost: *


30% Deposit Required: *


Balance Due: *


Security Deposit £100 / €130: *
£100
€130

I have read & agree your Terms & Conditions and am 18 years or older *