Name: ........................................
Address: ........................................
........................................
........................................
Post Code: ........................................
Telephone: ........................................
Email Address: ........................................
Holiday Dates: ........................................  Arrival Date (available 4pm)
........................................  Departure Date (vacate by 10am)


  Orchard Barn Garden Wing
Accomodation Required    
Number Of Adults    
Ages Of Children    
Pets    
Extra Facilities Required
Cot    
Perching Stool,
Shower Chair etc
   
Please telephone to discuss requirements.


Cost of accomodation £                Deposit enclosed £100.00 (inc VAT).
Balance to be paid 6 weeks before the start of your holiday.
I confirm that I have read and agree to the Terms of Business

Signed: .............................................................................

I would also be very grateful if you could let me know where you saw West Hele advertised

.......................................................................................... Thank you