Please complete this form and send to:

BRYNCALLED BARNS HOLIDAY

LETS, BUCKNELL, SHROPSHIRE

SY7 0BN

Provisional Booking Number

(Given by phone or when you booked)

_____________________________________________

Name (block capitals please)

______________________________________

Address (block capitals please)

______________________________________

______________________________________

______________________________________

______________________________________

Postcode_____________________________

Telephone Number

(Please include area code)

Daytime _____________________________

Evening _____________________________

Email Address

______________________________________

Name of Holiday Cottage

______________________________________

Holiday Dates

From                           To  

______________________________________        

(Date in)                      (Date out)

Number in Party

Adults_________________________________

Children (over 12ys) ___________________

Children (2-11yrs) _____________________

Infants (under 2 yrs) ___________________

Extra requested:

Cot (delete)                             YES/NO

Cot bedding and towels        YES/NO

High Chair (delete)                 YES/NO

How did you hear about us / Please enter website? 

_______________________________________

Initial Deposit

£_______________________________

    25% of the total holiday cost

Cheques to be payable to “Bryncalled Barns Holiday Lets”. Balance is due 6 weeks before commencement of holidays.

Full rent to be paid on bookings made less than 6 weeks before start of holiday

Declaration

I undertake to leave the property in a clean and tidy condition and agree to the booking conditions set out on the website. I am over 18 years of age

Signed____________________Date_________ 

Please note: Provisional bookings will be held for seven days for deposit and completed booking form.