Florida Hills US Booking Form

Florida Hills US Dollar Booking Form

Name

No. & Street

Town / City

State / County	Postal Code / Zip Code
	Country
Daytime Phone	Evening Phone
E-Mail

Arrival Date	Departure Date

Number of Nights	Method of Arrival

Please List ALL persons Occupying the Villa

Full Name and Age if under 21	Age on Arrival	Full Name and Age if under 21	Age on Arrival

Do you require the Baby Crib? If Yes which room would you like it in ?

Do you require the use of the High Chair

Wheel Chair Hire?

Are you celebrating anything special whist staying in our home?
eg. Birthday, Wedding Anniversary. If so please give details

Rental Rate

Amount Enclosed

Please Indicate your preferred method of payment: Check Bank/wire Transfer Credit Card**

**Please note that our published rates have been discounted by 5% for Cash, Cheque (Check), Bank Transfers, BACS and Wire Payments. If you wish to pay by paypal or credit cards then there may be an Admin fee of 5% but please check with us first.

Non US Residents - Please check with the passport office and the US Embassy for Passport and Visa regulations to America.
BY SIGNING THIS FORM YOU AGREE THAT YOU HAVE:-
READ, UNDERSTOOD AND AGREE TO ALL THE TERMS AND CONDITIONS RELATING TO THIS BOOKING AND CONFIRM THAT YOU ARE AUTHORISED BY ALL PERSONS LISTED TO MAKE THIS BOOKING ON THEIR BEHALF. THAT YOU ARE OVER 21 YEARS OF AGE AND AGREE TO PAY THE BALANCE 2 MONTHS PRIOR TO DEPARTURE. It is recommended that all party members obtain travel & medical insurance.

Signed Dated

Please complete and print this page, then press SUBMIT which sends the form directly to us, once received we will hold your dates for 14 days pending receipt of the signed form and deposit.

Please make your check payable to A & M Hill and send By AIRMAIL to
A & M Hill, 64 Morecambe Ave, Scunthorpe, North Lincs, DN16 3JG, United Kingdom

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THEN