Please print this page, complete in capitals and send to the address below with your cheque (£sterling) for 30% deposit (payable to " Riverside Cottage "). This must be done within 5 days of your telephone reservation.

Return to: Ian Mawby, Pulhams Mill, Brompton Regis, Dulverton, Somerset, TA22 9NT.

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RIVERSIDE COTTAGE BOOKING FORM

Hirers name:

Address:

Postcode

Home telephone number:                                        Daytime tel.no.:

Number of adults in party:

Number of children in party:
(MAXIMUM OF 6 PEOPLE)

Number of dogs (max 2) (£10 per week ea.):

Date from Saturday at 4pm:

Date to Saturday at 11am:

Special requirements (please circle)       Cot           High Chair

I have read and agree to abide by the terms and conditions

Signed (Hirer) :                                                                 Date:

Name: