• Important: Please telephone to confirm availability of the cottage before sending the booking form (01298 872462). All bookings are subject to the terms and conditions.

• Bookings will accepted when accompanied by the appropriate deposit and a signed and dated booking form.

• Please click here to read the Terms & Conditions before completing the booking form.

Please print the form and post your application to the address below:

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BOOKING FOR BANK TOP,  MILLERS DALE

Bank Top Cottage   c       Bank Top Holiday Home   c

 

Please tick against the property required

Name:    _____________________________________________________

Address: _____________________________________________________

 

              _____________________________Post Code ______________

Telephone:___________________________  Evening: ________________

email address:_________________________________________________
 

Total no of people in party: _______ [Total adults:_____ Children:____]
 

If bringing a dog please state breed:  _____________ (Supplement of £15)
 

HOLIDAY DETAILS

I require Bank Top Cottage/Holiday Home for (number)__________ nights
 

Arriving:   Saturday, _______________________________

Departing: Saturday, _______________________________
 

Any Special Requirement (eg late arrival etc)  ___________________

How did you find out about us?  _______________________________

PAYMENT DETAILS

 
Rent Payable:                     £ ______________

Pet Supplement (if any):      £ ______________

(£15 p/w if any):    

= Total Payable:                 £ __ __________

Deposit Enclosed:               £ _ _____________
(50% deposit or full rent if booking less than 8 weeks before commencement of holiday)

 

Please make cheques payable to MR R LEE and post with the completed booking form to:

Mr & Mrs R Lee

Bank Top Cottage,

Meadow Lane, Millers Dale

Derbyshire  SK17 8SN

I agree to forward the balance of rent not less than 8 weeks prior to the commencement of the holiday (10 weeks if residing outside Great Britain). I have read the terms and conditions and agree to accept the same. I have also read and understood the information brochure relating to Bank Top Cottage. I am over 18 years of age and acknowledge that my booking is for a holiday period only.

I agree to leave the Cottage in a clean and tidy condition, to make good all damages and breakages, and to vacate the Cottage at the end of the holiday period booked above.

SIGNED:  _____________________________________________________

 

DATE:     ______________________________
 

Thank you for your booking.

 

We will process the confirmation of your booking upon clearance of your deposit cheque.