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     Booking Form for “Pechine Chambres D' Hotes ”

Please copy and paste into a word document which can then be completed and attached to an email or printed and posted

                   return to : mikeburrowes@yahoo.com

 Name:  
 Add 1:  
 Add 2:  
 Add 3:  
 Address and   Post code:  
 Tel No :  
 E-mail:  
 No of Children:  
 Ages of Children:  
 No of Adults:  
 Arrival Date:  
 Departure Date:  
 Cot high chair etc required  
 Daily charge   50 euros (Low)         55 euros  (High)
 Deposit 30% :  
 Total payable  
  I have read and accept the general rental terms and conditions for “Pechine  Chambres D'Hotes”. I can confirm that I am over 18 years of age.
 Date  
 Signature