Booking Form

Please complete this booking form, print and sign, then send to:-
Ann Prosser, Waste Farm, Hurley, Atherstone, Warwickshire. CV9 2LR.
If you have any queries please email me at ann@hipsley.co.uk

Name:

Address1:

Address2:

Town:

County:

Country:

Postcode:

Tel:Day:

Tel:Home:

Fax:

Mobile:

Email:

Arrival Date:

Depart Date:

No. of guests:

* No. of dogs:

No. of children:

Ages of children:

Name of Cottage:

Please select item(s) and no. required:

One:

Cot (babies -linen not provided)

One:

Highchair (babies)

Any other requirements/groceries:

How did you hear about us?

Cottage TOTAL

£50 deposit enclosed, balance of due 4 weeks before arrival.

Method of Payment: Sterling cheque payable to Ann Prosser or

Signed.............................................................. Date....................

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