
Name :
Street Address:
City:
Province/State:
Postal Code:
Country:
Home Phone:	Provide at least 2 phone numbers
Cell Phone:
Work Phone:	Extention
Profession:
email:

Do you agree with these conditions:
1. There will be no pets brought to the cottage :
2. There will be no smoking inside the cottage :
3. The cottage will be rented for lodging ONLY, no parties or large gatherings:
4. The number of occupants will not exceed 6 at any time during your stay.
5. A security deposit of $750 [Click Here for More] will be provided before arrival:
6. You are responsible for any damages caused during your stay :
7. The owners will not be responsible for any incidents or accidents during your stay.

Note: You need to agree to all conditions to proceed. Please contact us if you need any clarification.

Today's date:

Arrival date:

Departure date:

Number of guests:

Approximate age of guests:

(Example: 45, 43, 12, 9)

Total rent agreed upon:

to be paid by:

Please double check your information and press SUBMIT

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