Brimeux Properties - Holiday Homes in Northern France

Please use this form to make a booking (* = Required Information)

Before completing this form please: 1. check the availability page to ensure your desired period is available 2. review the prices page 3. read the Terms and Conditions relating to the renting of the property.

Your details:
Contact Name:			*
Email Address:			*
Postal Address:			*

Town:			*
Post Code:			*
Contact Telephone:

Your party details:
Party Numbers:	Adults:	Children:	*
Name 1:			*
Name 2:
Name 3:
Name 4:
Name 5:
Name 6:
Name 7:
	Additional baby (under 18 months)

Your stay:
Gîte Required:	Les LavandesLes Roses		*
Arrival Date (dd/mm/yyyy):			*
Departure Date (dd/mm/yyyy):			*
Bed linen is available at a cost of £15 per bed:
	Tick this if you require linen If so, which beds do you require?			(Note: if you do not opt for linen, duvet covers, sheets and pillow cases will not be provided. Tea towels will always be provided. We do not provide bath- or hand-towels.)
	Double Bed Single Bed 1 Single Bed 2 Triple Sleeper (Double Part) Triple Sleeper (Single Part)


And finally:
	Tick this box to confirm that you have read, and agree to be bound by, the Terms and Conditions.	*
	Tick this box to confirm this as a true and genuine booking request	*
	How did you hear of Gîte Brimeux? 'Visit France' web site 'First4France' web site 'Our Gites' web site 'Holiday Lettings' web site I'm a previous visitor General Web Search Other (please specify)	*
	Additional Booking Comments:

	When you have completed all the parts of the form click the submit button to send the details.