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Name

First

Last

Phone

Home Town/City

Company Name

Company Registration Number

Company VAT Number

Number of Couples

Number of Males Single

Number of Males Sharing

Number of Females Single

Number of Females Sharing

Number of Children u/14

Pets: If you have pets, please let us have details.

Do you have a large truck/long trailer?

Yes

Preferred Room/s

De Blauwe Kamer sleeps 2

De Franse Connectie sleeps 5

De Afrikaanse Nachten sleeps 5

De Kippengreep sleeps 4

De Melkstal sleeps 6

De Schaapskooi sleeps 6

De Overloopkamer sleeps 3

Date of Arrival

Date of Departure

If you are human, leave this field blank.

De Plaashuis