reserveringsformulier

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Reservation Request Form

* These fields must be filled in

First name

Last name

Address 1

Address 2

ZIP code

City

Country

Telephone number

Fax number

Email address

Arrival Date

For example 05/07/2008

Click here for planner

Departure Date

Transportation

Camping equipment

Member of INF

Remarks

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* Only fill in these fields
	Number	Price Low season	Price High season	Total
Tent, trailer, Caravan	*	� 7,00	� 8,75	�
Camper	*	� 10,00	� 12,50	�
Persons above 12 years	*	� 4,80	� 6,00	�
Persons up to 12 years	*	� 4,80	� 6,00	�
Car	*	� 1,80	� 2,25	�
Animals	*	� 1,80	� 2,25	�
Electricity 4A ( Y or N)	*	� 3,50	� 3,50	�
Electricity 10 A ( Y or N)	*	� 4,50	� 4,50	�
Click here to calculate total
You booked days in the high season
You booked days in the low season

Total in EURO (discounts excluded)	�
Prepayment	�
Booking fees	�
Total Prepayment in EURO	�

I agree with the reservation conditions and tarifs.		* Type agree	Submission of this form is a request for a reservation and availability is not guaranteed.
	Click here to submit your reservation

We advise you to print this reservation request form. After receipt of your deposit we will send you a final confirmation.

Le Coteau de l'Herm
Shirley & Jaap Overdulve
Ld. Lacoste
F-24580 Rouffignac
France
GPS: 45,07095 N 0,97207 E

Tel: (+33) (0)553466777
Tel/Fax Nederland:
(+31) (0)30-2285433

Open/Ouvert: 15/5-16/9

Postadres Nederland
Le Coteau de l'Herm
Shirley & Jaap Overdulve
Obrechtlaan 22
3723 KC Bilthoven
E-mail: info@naturisme-dordogne.com

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