Emerald Gem Booking Form

Please print clearly in block capitals

Address ........................................................................

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...............................................................Post Code.............

Telephone ........................................... e-mail ..........................................................

Please list the names of everyone who will be staying at the villa and the ages of everyone under 21. (This is a requirement under Florida State Law).

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Date of arrival ................................... Date of departure .................................

Arrival airport (so we can send the relevant directions) .................................

Do you require Pool heat (including the Spa) yes / no (additional charge)

I have read & accept the terms and conditions of booking and include a signed copy with this booking form. I enclose a deposit of £150 / $250 per week and agree to pay the balance due in full no more than 8 weeks before arrival. Cheques to be payable to Mrs E Boxall.

Signed ........................................................... Date ................................

Print Name ....................................................

Following clearance of your deposit a receipt will be issued and an invoice for the balance due will be forwarded to you.

Please send this form, your payment and signed terms and conditions to :

Mrs E Boxall 109 Allington Way, Maidstone, Kent. ME16 OHS U.K.