Rose Narrowboats Canal Holiday Booking Form

BOAT/CLASS REQUIRED

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No. of WEEKS/NIGHTS

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START DATE

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FINISH DATE

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START/FINISH TIME.

Weekly Hire (Tick one box only)

Fri. 2.30pm/Fri. 9.30am

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Sun. 10am/Sat. 5pm

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Sat. 2.30pm/Sat. 9am

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Mon. 2.30pm/Mon. 9.30am

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START/FINISH TIME.

Breakaway (Tick one box only)

Fri. 2.30pm/Mon. 9.30am

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Mon. 2.30pm/Fri. 9.30am

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FULL NAME

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ADDRESS

..............................................................................................
..................................................POSTCODE

TELEPHONE

.HOME....................................

.WORK...................................

NUMBER OF PEOPLE IN PARTY

TOTAL -.........

.ADULTS - .......

UNDER 12-......

WE WISH TO BRING OUR PET(S) For which a charge of £25.00 per booking is made to cover extra cleaning

No. of pets

.....

WE REQUIRE OVERSEAS VISITORS KIT (One large and one small towel per person, tea towels and first aid box). Cost of Kit - £10 per week per boat

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Buoyancy aids and car parking for up to two cars are provided free if required.

WE HEARD OF YOU THROUGH

..............................................

WE HAVE BOOKED WITH YOU BEFORE

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Initial Payment

DEPOSIT - 25% of boat hire fee	£............	........p
BOOKS & MAPS	£............	........p
TOTAL AMOUNT ENCLOSED (Cheques payable to Rose Narrowboats Ltd.)	£............	........p

OR CHARGE TO MY VISA/ACCESS/AMEX CARD

NAME ON CARD

..............................................

EXPIRY DATE

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CARD SECURITY CODE

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(Last 3 digits on card reverse)

SWITCH CARDS ONLY

ISSUE No.

.............................

START DATE

.............................

Please list details of all members of your party (we need these for our insurance).

Title	Initials	Name......................	under 5	Age 5-12	Age 13-18	Age 18-25	Age 25+

SIGNATURE

DATE

I declare that I am over 21 years of age, and have read the conditions of hire, and agree to be held responsible for the balance of hire in accordance with those conditions.

Final Payment
Your final invoice which you will receive later, will include the balance of the hire fee and the Damage Waiver of £40

For office use only
.