Reservation Form REDFIELD COTTAGE Lower Beverly Lake, Delta, ON sleeps 4-6, max

Dates Reserved: _______________________ E-Mail Confirmation # ___________________ COTTAGE RATE:  700/wk (4-6 occupants)               (+$15/night per extra person over 4) No. Guests Booked: __________ Bal. Due @ Check-in:    (Canadian $ CASH ONLY):  $700

1.  Person responsible for rental, please print out form, fill out completely and legibly, sign. 2.  Get Confirmation # given on email that confirmed your dates (SUBJECT LINE of email) 3.  Mail this signed Reservation Form and signed Contract to address given to you in body of above email.   Reservation will be cancelled if not filled out completely or received within two weeks of email confirmation.  (You may REFER to Rental Cottage Information sheet to clarify procedure) Thank  you, and see you soon!!!!!!!!!                         BACK

*Bring own linens, clothing, food, garbage bags. *Tested, potable well water *Pets must be OK'd prior to reserve NOTE: no refunds due to acts of God (electrical outages, etc)

PLEASE PRINT: I have read, understand and agree to all stipulations above, & on attached Contract. NAME: ________________________________________________________________ Street:  ________________________________________________________________ City:  ________________________  State/Prov: ______ Zip/Postal Code: __________ E-MAIL ADDRESS:  _________________________________ (PRINT) Telephone (home) ____________________________(work) _____________________ Required: Credit Card # (must be same person above): _____________________________________________   Exp Date:________   Last three numbers on back of card (security code): ___________ CCard not used for rental fee (cash only); used only for damages, and/or $200 Cancellation Charge if we do not receive cancellation requests by 60 days prior to arrival date.  No charge, If we are able to rebook. Card Owner Signature/Agreement: ____________________________________________________