RESERVATION FORM
houseatdisney.com
Return to:
LAUREL COHEN
P.O.
E-MAIL: jensdisney@comcast.net
978-562-4132
978-235-2528 (cell)
MAXIMUM OCCUPANCY 8 PEOPLE
TO WHOM SHOULD ALL BOOKING CORRESPONDENCE
BE SENT:
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FIRST NAME |
LAST NAME |
STREET ADDRESS |
CITY, STATE ZIP CODE,
COUNTRY |
TELEPHONE
NUMBER; COUNTRY CODE, IF APPLICABLE |
E-MAIL
ADDRESS |
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( ) |
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OTHER GUESTS
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MR/MRS MISS/MS |
LAST NAME
OF ALL GUESTS |
FIRST NAME |
AGE (IF
UNDER 21 YEARS) |
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POOL HEAT |
ARRIVAL
DATE |
DEPARTURE
DATE |
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____YES
____NO ADDITIONAL FEE APPLIES |
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PETS |
** PETS ARE
ALLOWED BY SPECIAL ARRANGEMENT ONLY ** |
STATE TYPE, APPROXIMATE WEIGHT & NUMBER
OF PETS |
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____ YES ____ NO |
PET FEE: $30 PER WEEK PER PET SECURITY DEPOSIT FOR FAMILIES WITH PETS IS: $400.00 |
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I
have received a copy of and agree to accept “Reservation Terms &
Conditions” on behalf of all persons
listed on the reservation form. I certify that I am over 21 years of age.
_____ I am enclosing a check for
20% of the total amount due (minimum deposit to hold reservation is $200.00
USD). Make check payable to Steve or Laurel Cohen
(
_____ I request you bill me
via PayPal. (
reservations
less than 5 weeks prior to scheduled arrival. Sorry no e-checks accepted less
than 5 weeks).
_____ I would like to do a
wire transfer of funds. Please send me instructions for wire transfer.
_____After my departure
(presuming no damages)
I would like my security deposit returned by check to the above
address.
_____After my departure
(presuming no damages)
I would like my security deposit returned to my PayPal account.
Signature: Date:
Must be 21 or older to sign
DOO:
4/24/2008