Please print, complete, sign, and send to

Painting-Photography-France, "Les Peupliers", St Juin, 47400 Lagručre, France

If you would prefer to do this electronically, click here to get an MS Word version of the form which you can complete, save, and then email as an attachment to    peter.evans@painting-photography-france.com

Booking Form
  (each person must complete and sign a separate form, but one payment to cover all will suffice)
Desired Arrival Date   Discipline Req'd  Painting    Photography  
Room requirement Double   Twin    Single    Child Sharing  
Gender Date of Birth    
Title

Forename

  
Surname  
Postal Address  
Contact telephone No.   Email :
Special Dietary Requirements (if any) Medical conditions Allergies Disabilities
(Note: unfortunately we are unable to cater for wheelchairs at present)

Please detail below any special needs you may have or conditions we should be aware of, as above -  (see Terms and Conditions)
 

 Accommodation / Holiday Cost (One Person) 

 

Deduct 'non-participating partner' discount (30%) for this person, if applicable 
 or Deduct 'child room sharing' discount for this person (50%), if applicable 
please note: only ONE of the above discounts may be deducted 

 

Sub-Total 

 

 Add single Occupancy supplement, if applicable 

 NIL

Add week-day arrival supplement if required, leave blank if not applicable

 

Total Cost in Euros (applicable to all non-UK residents) 

 

 Total Cost in Pounds Sterling (applicable to UK based clients only) 

 Ł

Declaration :
I declare that I am reasonably fit , that I will inform Painting-Photography-France of any relevant medical condition or concerns that I have and that, before arrival, I will ensure that I have adequate insurance for all eventualities (including medical and accident emergencies, cancellations, transport delays etc). I understand and accept that Painting-Photography-France will have no liability in this regard. I undertake to pay 25% deposit now and the balance of the cost of my trip 8 weeks before my arrival date. I am aware that if I wish to cancel more than 8 weeks before my arrival date I will lose my deposit and that, should I cancel less than 8 weeks before my arrival date, I will lose 75% of the total if my place cannot be filled.   If the place is filled I understand I will receive a full refund less 15% to cover administration costs.  I understand that any cancellation must be made in writing. I understand that non-payment of the balance by the due date will also be taken as a formal notice of cancellation. I understand that Painting-Photography-France may have to change any itinerary without prior notice for logistical reasons. I understand that should Painting-Photography-France have to cancel my booking for any reason then I will receive a full refund (without deduction) and that Painting-Photography-France will have no further liability. I undertake not to smoke anywhere in the property or pool area and outside only where permitted. I declare that I have read and understood the Firm's Terms & Conditions and confirm that I  agree to abide by them. Please accept my booking as detailed above.

Name ___________________________  Signed * ______________________  Date_________
                                                                                              * parent or guardian to sign on behalf of child