AA 

RESERVATION FORM
To: Mr & Mrs J. C. Dascombe
Burrowhayes Farm,
West Luccombe, Porlock,
Minehead, Somerset. TA24 8HT

English Tourism Council - 4 Stars

PLEASE PRINT THESE PAGES TO COMPLETE THE FORM AND POST TO THE ADDRESS ABOVE
 SITE BOOKING Deposit Required: £15.00 per pitch per week or part week.

Caravan pitch required for:
 
Touring Caravan
 Folding Caravan/Camper
 Motor Caravan
Length of caravan________ ft
 16 Amp electric hook-up
 Full Awning
 Porch Awning
 Extra Car
 Pup Tent

Tent
pitch required for:
 
Frame/Ridge Tent
 Trailer Tent
 Dome/Tunnel Tent
 16 Amp electric hook-up
 Extra Car
 Pup Tent
Gazebo
Please indicate size of tent:
 Small   Med   Large
If Large approx. size: ______ ft x ______ ft

My party consists of:
Adults_____________ Children 3-15yrs______________Under 3's______________ Any Dogs?________

Dates required: Arrival:________________ Departure:_________________ Number of Nights:__________

Name:___________________________________Address:_____________________________________

____________________________________________________________________________________

Postcode:__________Telephone:_____________________Email Address:_________________________

Please accept my reservation as detailed above.
 my cheque for £__________ is enclosed, payable to "Burrowhayes Farm"
 Please debit £__________ from my Visa/Mastercard/Switch card
 ,  ,  ,  , 
Valid From  / Issue No. (Switch)________
Expiry Date
/ Security Code (Last three digits of number on signature strip)
Please note any additional requirements:_______________________________________________

I understand that once the booking has been acknowledged, the deposit is not returnable. I have read and agree to abide by the terms for reservations stated in the 2008 tariff.

Signed:_______________________________ Date:______________________________

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