Rose Cottage
Barton-on-Sea, Hampshire

Booking Form

If you would like to make a booking, please read the attached terms, conditions and booking details. You may wish to check the availability of ‘Rose Cottage’ for your chosen dates before submitting this form, by either telephone or a Fax message. If you have any questions or would like more information, please contact the Owner, Patrick Higgins on 01425 613406.

This form must be accompanied by your cheque, made payable to Patrick Higgins, and sent to the following address: ‘Rafters’, 9 Dilly Lane, Barton-on-Sea, Hampshire, BH25 7DQ.

YOUR NAME:	…………………………………………………………………..

YOUR ADDRESS:	…………………………………………………………………..

…………………………………………………………………..

YOUR HOME TELEPHONE/FAX NO:	…………………………………………..

MOBILE TELEPHONE NO:	…………………………………………………..

OTHER GUESTS – NAME AND ADDRESS (if different from above):

1st……………………………….

3rd……………………………….

4th……………………………….
5th……………………………….

6th……………………………….

CHOICE OF DATES:

1ST CHOICE:		From.………………….    	  To.………………….

2nd CHOICE:		From.………………….    	  To.………………….

I declare that I am over 18 years of age and that I have read the attached booking conditions, understand them and agree on behalf of myself and all of my party members, to abide by and be bound by them and to make all payments in relation to them.

SIGNATURE: 	…………………………

DATE:		…………………………