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Please print this page in black & white, complete and send to us. Please note that confirmation of booking will only be issued once deposit and booking form have been received.

                                                Booking Form
                                          PLEASE USE BLOCK CAPITALS

            Return To: Julia Groom, 1 rue du Pont, 66600, Espira de L'Agly, France      
Full Name:
Address:




Home Tel:                                                    Day Tel:
Email:                                                          Fax:
No. of Weeks Required:               Arrival Date:                    Departure Date:

No. 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 have read and agree to the BOOKING CONDITIONS

I confirm that a non refundable deposit of £_______  being 25% of the total holiday cost has been deposited to the nominated bank account on …………………...(date). I agree to pay the balance of £______  , plus a returnable damage deposit of £100 for La Petite Maison and 150 for the other gites, 8 weeks before the start of the holiday. (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

Please indicate which airport or direction you will be arriving from and we will send you detailed directions of how to find us closer to the booking.

________________________________________________________________

 
Signature:                                                      Date:

               Source of advertisement Roussillon Breaks Website
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