Chez Rogers - Booking Form

To make a provisional booking please print and send this form to my address in Canada or forward to me via e-mail. Alternatively, you can let me have your outline requirements in an E-Mail.

Mr David S. Rogers' e-mail:-David S. Rogers tel. (001) 613 584-2815 at 26 Faraday Crescent, DEEP RIVER, ON., CANADA K0J 1P0

I will then reply by E-Mail to confirm the booking and to let you have our home address so that you can send me a copy of the signed booking form in the post together with your cheque for the deposit. Please note that, if the booking form and 25% deposit are not received within 15 days of my confirmation, the booking will lapse.

BOOKING FORM

To: Mr David S. Rogers

From (Name): ...............................................

Address: ............................................

.....................................……..............

....................................….…..............

........................................……...........

Tel No.: ...............……....…...(Home)... .......…….................(Work)

Number of guests: Adults.....................Children.....................

Date of intended arrival:......................... (after 3 pm)

Date of intended departure:......................(before 10 am)

I enclose $Can/£/Euros................being 25% of total rental of $Can/£/Euros................ (Payable to: Mr David S. Rogers.)

I/we understand that you accept no claims for personal injury and we are therefore responsible for insuring ourselves accordingly.

Signature:....................................................