Kate Sampson, 11 rue des 2 ponts,11220 Lagrasse, Languedoc France

Which Gîte		Print this form
Booking period	From:	To:
FULL NAME
ADDRESS
HOME TELEPHONEMOBILE TELEPHONE
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Names and ages in party:

To help us prepare for your stay please specify sleeping arrangements. We provide all bed Linen, bathroom hand towel, bath towel and tea towels. Please note that we DO NOT provide swimming towels. Circle requirements
Riverside Gîte
Kingsize double bed	2nd kingsize double bed	single bed
Single futon	sofa bed	cothighchair

Balcony Gîte
Kingsize double bed	Double bed	single bed
sofa bed	cot	highchair

Rental cost Total cost- deposit paid.....		+ cleaning cost (optional 50€ ) = total cost€ Date Paid= balance due €
A Security/Cleaning Deposit of £150/150€ is required and should be paid with a separate cheque (sterling cheque if UK resident) when you pay the balance. (please specify mode of payment: bank transfer / bankers draft / IMO)

NB. The 30% Deposit which is required before a booking can be confirmed is non-refundable should the booking be cancelled. )

I HAVE READ YOUR TERMS AND CONDITIONS AND ACCEPT THEM ON BEHALF OF ALL MY PARTY WHO WILL RESIDE IN THE PROPERTY, ON WHOSE BEHALF I AM DULY AUTHORISED TO MAKE THIS AGREEMENT. I AM OVER 18 YEARS OF AGE.

DATESIGNED

Please state where you heard about us:

Please return form to Kate Sampson, 11 rue des 2 ponts,11220 Lagrasse. Languedoc France