Name:

Address:

E-mail:

Daytime phone number:

Evening Phone Number:

How did you hear about us?

Is this a repeat visit? YES NO

How many adults in the party? 0 1 2 3 4 5 6 7 8 9 10

How many children in the party? 0 1 2 3 4 5 6 7 8 9 10

Which cottage would you like to book? Straidkilly A Straidkilly C Straidkilly B Glen Rock Strand House Strand Annex Awelon Murlough

Please enter in the dates you would like to book your cottage in the format of day, month and year, e.g.. 16th June 2000 - 23rd June 2000.

Dates:

Cot (free) YES NO

Highchair (free) YES NO

Extra Turf £2.00 per bag YES NO If yes how many? 0 1 2 3 4 5 6 7 8 9 10

Flowers (purchase price) YES NO

Groceries Goods + £5 service charge YES NO

Cleaning service £6 per hr (all payable on arrival) YES NO
If yes how many hours? 0 1 2 3 4 5 6 7 8 9 10

Any additional comments or queries?

NOTE: By submitting this form you confirm that you have read and understood the terms & conditions outlined in the terms & conditions section.