Au Chicot - Booking Form
PLEASE USE BLOCK CAPITALS, and remember to include cheque for your deposit
 
Full Name  
Address  
   
   
Post Code  
 
Telephone Day:   Mobile:  
  Eve:   email:  
 
Number of weeks required    Number of Adults (16 or over):  
     Number of Children (Under 16):  
 
Arrival Date   Departure Date  

Names of all party members (Please give ages of children):
 

 
 
    I enclose a non-refundable deposit, being 25% of the total holiday cost £  
    I agree to pay the balance 8 weeks prior to the start of the holiday £  
    I also agree to pay a refundable damage deposit of £200 per week of holiday £  
OR (If booking is within 8 weeks prior to the holiday start date)    
    I enclose the full amount (including the refundable damage deposit) £  


I am authorised to make this booking on behalf of all my party. I am over 18 years of age
I confirm that I have read and accept Au Chicot terms and conditions
 

Signed
 		       Date  
 

Please return this form to:

   Jane Bennett
   Millers Gate
   Church Street, Newport
   Saffron Walden
   Essex CB11 3RA
   England

 Enter any special requests here (continue overleaf if needed)
 

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