Title

Initials

Last Name

Address

Postal Code

Work Phone

including full area code

Home Phone

including full area code

E-mail

Number Adults

Number under 18

Age of Children

1st Choice

Date of arrival

-- mm/dd/yy

Date of departure

-- mm/dd/yy

Estimated arrival time between 3pm & 6pm

2nd Choice

Date of arrival

-- mm/dd/yy

Date of departure

-- mm/dd/yy

Select as appropriate your requirements for all of the following items.

Smoking

Non-smoking  Smoking           

Pets

Yes    No 

Number 

Age

Breed

High Chair

Yes    No     number required

Cot

Yes    No     number required

Deposit

Please make cheques made payable to J & D Hughes

Holidays of £300 and over deposit of £90 per week booked
Holidays up to £299.99 a deposit of £70 per week booked
I enclose a deposit in sum of  £70    £90

I have read and agree to the terms and conditions; signed:

Please complete all details, print, sign and return with deposit to 
Tyddyn-Hendwr, Llandrillo, Corwen, Denbighshire, North Wales, LL21 0SN