Full Name and Address:  
 Home Telephone:     Mobile Telephone:  
 Fax:    Email:  
 Number in Party:     Adults:    
 Children (Ages):  
 Arrival Date:     Departure Date:  
 Special Requirements (cots etc.):   
 Deposit (20% Enclosed):  
 Rental Balance:     (balance due 8 weeks before arrival)
 Damage Deposit:   
 I have read the TERMS AND CONDITIONS of rental   YES ____
 Date:    Signed:  
 Please print this form and forward to:
        Helen & John Stiven, Mulina, Pyrford Woods, Pyrford, Woking, SURREY, GU22 8QT
        Cheques Payable to MR. & MRS. J STIVEN