Lauralee Holidays Booking Form

Name & Address

Please include E-mail address Car Reg

           Your Phone Number (Please include STD No)


Emergency contact number / Mobile

Week No

Arrival Date

Vacate Date

No Nights stay

            Your Party


Teenagers (12 to17 )

Children ( 3 to 12 )


             Your Holiday Payments

Short Breaks ( Nights ) ( Recommend you order a on-street Car parking permit)


Full Week ( 7 Nights ) (1 free on-street car parking permit)


Two Weeks ( 14 Nights ) (2 free on-street car parking permit)


Key & Damage Deposit (returned to you after 14 days of vacating)


On-street Car parking permit £5 each, Recommend for short stays, or extra permits


Service surcharge


Discount Based on :-returning client Saving £

Total Grand Balance




Total Balance



               I have accepted the Term & Conditions of hire and I am 18 and agree to be held responsible for the balance of hire for the property Duo in accordance with the                 booking conditions and to be responsible for any damages that might occur. No smoking or pets aloud

I agree to pay the Full Balance Duo 8 Weeks before Arrival Date

Signature :


           Cheques to be made payable to Mr J W Hilton or payable via Pay-Pal but there is 5% charge or with arrangement's by Bank Transfer 

          Please return to, Mr James William Hilton Grange Cottage, 6 Kendal Drive, Bolton on Dearne, Rotherham, S63 8NJ