Booking Form for
"La Maison des Deux Clochers"

If you have any questions or doubts about how to fill it out, please contact us for assistance

1.

Please fill out this page - you can do this directly on the screen

 

2.

Print_it

 

3.

Send it along with your deposit cheque - see mailing instructions below

Please note that we will be unable to process your reservation without receiving BOTH the completed signed booking form and deposit.

First Name: 

Last Name:

 

 

Address:

 

City / Town: 

 

 

Province/State:

ZIP Code:

Country: 

 

 

Phone: 

Fax: 

Mobile:

Email:

   
Arrival Date:     (e.g. May 1st, 2007) 
Departure Date:     (e.g. May 15, 2007
   
Comments:

The House will be occupied by  people:

Name

Age

Email

1.

2.

3.
4.

We can provide a high speed internet connection for those clients bringing their own computers. 

Will you be requiring an internet connection?            YES            NO

We can provide some assistance in regards to the planning of activities during your stay - French lessons,  wine or cooking classes,  walking tours, etc.

Would you potentially be interested in having us help you plan some activities during your stay in Burgundy?             YES            NO

Cancellation Policy- Our cancellation policy is as follows: 

Herewith I declare my booking.  In doing so I acknowledge that I understand and agree to the cancellation policy and the house rules

I also agree to send a 200.00 EUROS damage deposit along with my final payment.

I agree to pay for the utilities (water/electricity/phone) consumed during my stay.

I agree to leave 40.00 Euros at the house for the cleaning crew upon departure.

Date: 

 

Signature:

 

Please note that we will be unable to process your reservation without receiving BOTH the completed signed booking form and the cheque.

PLEASE MAKE CHEQUE PAYABLE TO:

LAURA BRADBURY

- Payment via wire transfer can be arranged on request -

For payments in
US or CANADIAN DOLLARS

Please send this page along with your deposit cheque to:

Laura Bradbury
c/o Bradbury Management Ltd.
814 Broughton Street
Victoria, B.C., V8W 1E4
CANADA

For payments in
EUROS

Please send this page along with your deposit cheque to:

Laura Bradbury
1, Rue des Chaumes
21700 Villers-La-Faye
FRANCE