Please provide the following information by email to
shales99@gmail.com or print this page and post to:
Susanne Hales, Stony Cottage, Jumps Road, Churt, Farnham, Surrey, GU10 2LB
Full Name: ________________________________________
Full Postal Address: ________________________________________
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Home Phone: ________________________________________
Mobile Phone: ________________________________________
Email: ________________________________________
Rental Period
Arrival Date: ________________________________________
Departure Date: ________________________________________
Number of Adults: ________________________________________
Number of Children: ________________________________________
Age(s) of Children: ________________________________________
Special requirements,
Or comments: ________________________________________
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Weekly rental periods are from 4pm Saturday to 10am Saturday following.
Total Rental Cost (refer to price and availability): £ ____________
Depost (20% of Total Rental Cost): £ ____________
Balance due 6 weeks prior to arrival date: £ ____________
I accept the terms detailed in
www.lalorrie.com/terms on behalf of all members of my party on whose behalf I am authorised to to make this agreement. I also confirm that I am over 18 years of age.
Print full name: ____________________ Signed: __________________
Dated: ___________________________
Please make cheques payable to Susanne Hales at the above address, bank details for BACS transfer available on request.
Full address of house: La Lorrie, Le Mesnil Garnier 50450, Normandy, France.