1999 Printable Reservation form

Last Name:__________________________________________________
First Name:________________________________Initial:_________

Preferred Mailing Address: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ 

City:_____________________________ State:________ ZIP:_________________

Province:_________________________ Country:____________________________

Telephone:_______________fax:_______________ 
e-mail:___________________

Reservation details:
Enter return EMAIL address 

Date of arrival (day/month/year ): ______/____/_________

Estimated time of arrival:. ___________________ 

Number of nights/weeks/months: ________________

Nr of adults _____ Nr of children _____

Type of camper _____

Length of camper _____

Type of hookups

Basic                      Yes _____No_____
Electric and water 15 amps Yes _____No_____
Full service 30 amps       Yes _____No_____
Full service 50 amps       Yes _____No_____


Services required:
 
 Swimming pool                       Firewood    .

 Tennis courts    .                  Tourist information    . 
 

How did you hear about us?
 ___ friends                     ___ Advertisement
 ___ tourist guides              ___ Woodalls 
 ___ in the Web                  ___ Canada's park directory
 ___ XXXXXXXXXXXXXX              ___ XXXXXXXXXXXXXX
 ___ XXXXXXXXXXXXXX              ___ XXXXXXXXXXXXXX 
 ___ XXXXXXXXXXXXXX              ___ XXXXXXXXXXXXXX 
 ___ XXXXXXXXXXXXXX              ___ XXXXXXXXXXXXXX 
 ___ Other: please specify _____________________ 

Comments and specific requests, What I hope to get out of your stay with us:
________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Payment:

 
 ___ Visa           ___ MasterCard          ___ American Express
 
 Name 
 (as it appears on credit card):______________________________________
 
 Acct #:___________________________________ Expiration Date:__________

 Signature:___________________________________________________________
 
 ___ Check enclosed

Please send checks in Canadian dollars or equivalent value in US dollars to:
 
                       Bissels Hideaway
                       205 Metler Road
                       R.R.I. Ridgeville (Font Hill), Ontario
                       Canada, LOS 1M0
                       Phone: (905)-892-5706
                       Fax:   (905)-892-5519
                       Email: IZANDED@aol.com                                     
                       April 16, 1999
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                       Copyright © Bissell's Hideaway


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