Post Code: 
 
      names  are required for Butlins passes - thank yoU.
 
How many Adults:             How many Children:                        Age if Under 18:
 
Mr, Mrs (etc)    First  Name:                 Surname:                           Age:
 
  1  
 
  2  
 
  3  
 
  4  
 
  5
  6  
 
  7  
 
  8  
 
Start Date of Holiday:        /         /          End Date of Holiday:        /         /
 
Duration of Holiday: [      ] nights:
 
payment information
 
Cost of Holiday: (as stated on prices)
 £
Deposit: (£100 per week)
 £

Breakage Bond (£50 )
 £            
Total Balance.
 £
Total Balance Due Date:  Due 6 Weeks before Holiday Start Date.
     /      /
 Deposit to be received within 10 days of booking.
 Breakage Bond (£50 per week) This is refunded to you by post (less cost of any damage) following caravan checks
Please make cheques payable to: Ms. k. tustin (inc your name, holiday start date & holiday reference number on the back of all cheques)
 
declaration
 
I understand, that as the head of party named above I sign on behalf of myself and the whole party, and that I have read, understand and agree to be bound by the terms and conditions of reservation.
 
Signature:                                                                          
  Date: