Booking Form

Please complete in BLOCK letters then print the form, sign it and return it to
ACCESS VILLAS by MAIL or FAX. Fax No. 01942 891811
Please telephone 01942 888844 to check availability.

MAKE SURE TO SCROLL DOWN THE PAGE AND FILL IN THE WHOLE FORM

Holiday details

Name of Accommodation


Date of Arrival
Alternative Date
Number of Nights
Number of Travellers

Type of accommodation
Please give details of your flight/arrival times

	ARRIVAL	DEPARTURE
Dates
Flight Numbers
Time
Airport

Passengers

Mr/Mrs/Miss	First Name	Surname	Nationality

Address of first named who is also signing the booking form

TELEPHONE

EMAIL ADDRESS

If any of the above are aged under 16 years please give name and date of birth
If more than 1 child please give details in SPECIAL NOTES box

Do you require a baby's cot (extra charge)?

Name of Disabled Traveller

IF MORE THAN 1 DISABLED PERSON PLEASE GIVE DETAILS IN SPECIAL NOTES BOX

Date of Birth

Condition or Disability of above named

If you require the HIRE OF ANY EQUIPMENT please give details in SPECIAL NOTES box

CAR RENTALS (if applicable)

Driver's Name

Number of years driving Age

Hand-control cars are available in Florida on request

What type of Vehicle do you require?

Is Passenger confined to a wheelchair

Can they transfer to and travel in a standard car?

Are you taking your own wheelchair?

Does it collapse for transportation?

Are you taking a powered wheelchair?

This form has to be printed out and signed then posted to ACCESS VILLAS together with your remittance or credit card details to cover either your deposit or the full amount therefore no details are transmitted over the internet
PAYMENT DETAILS- If you prefer you can print the form out and then fill in your details by hand
Deposit/Full amount per person		£
Insurance per person		£
Sub Total		£
Cheque Enclosed		£

CREDIT AND DEBIT CARD PAYMENTS
Please debit my
Issued by BANK:
NUMBER
Valid from	Valid to	Issue Number
Amount		£ plus 1.5% Credit Charge
Total to be debited		£
Signature ………………………………………………………………
THIS SECTION MUST BE SIGNED All special requests or specific requirements must be included on this form or in a separate letter Lack of information, in writing, may result in a misunderstanding of your needs. On behalf of those named above I agree to the conditions of Booking as shown hereafter. Signed………………………………………………………………………………… Date……………………………………………………………
SPECIAL NOTES Please complete in BLOCK letters then print the form, sign it and return it to ACCESS VILLAS by MAIL or FAX. Access-Villas 6 The Hillock, Astley, Lancashire M29 7GW Tel: 01942 888844 Fax: 01942 891811 Email: info@access-villas.co.uk Please telephone 01942 888844 to check availability. Home Page \| Booking Conditions \| Properties