Please complete in Block Capitals.

Surname: ………………………..(Mr/Mrs/Miss/Ms) Forenames:………………………...
Address: ……………………………………………………………………………………
……………………………………………………………………………………………...
Post Code: ………………..Tel No: ………………. e-mail: ………………………………
Other Adults (18 years of age and over:
1)…………………………………………….   2) ………………………………………...
3)…………………………………………….
Children (under 18 years of age):
1)……………………………….  Age: ……..   2) …………………………… Age: …….
3)……………………………….  Age: ……..
Dates Required: From: ……………...To: ………………….       

                                                                             Rental Price Per Week        £….………
                                                                             Multiply by No. of Weeks    ………….
                                                                                                                         £………….
                                                                             Less 25% Deposit               £………….
                                                                             Rental Balance                   £………….
                                                                             Plus Security Deposit         £………….

                                                                      TOTAL BALANCE DUE       £………….

Plus Linen Packs: Number of people at £5 per pack per week                       £………….

TOTAL BALANCE DUE 8 WEEKS PRIOR TO DEPARTURE                 £………….

Please make cheques payable to:     MK & PI Harrison
Number of cars: .....…Anticipated time of arrival: ........…
Holiday Insurance:  YES / NO
Are there any special needs for any members of your party?...........................................…
……………………………………………………………………………………………..

DECLARATION:
I have read the booking conditions as supplied and accept them on behalf
of all my party. I am over 18 years of age.
Signed: ………………………............................................. Date: .............................…

Please complete and sign this form and send it, with your payment to:
Mr & Mrs M Harrison, Michouat, Vidou 65220, France