BOOKING FORM b

PLEIN AIR OIL PAINTING – CHARENTE MARITIME, FRANCE 

WITH DAVID JOHNSON 

16-22 SEPTEMBER 2019

Details of Person Nominated & Responsible for Booking

Name………………………………………………………………………….………………………………………………………………………

Address for Correspondence: ………………………………………..……………………………………………………………………..

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Home Tel No: ……………………………… Daytime Tel No:………………………..…………………..……………………………..

Mobile:………………………………………….

Email address:…………………………………………………………………………………………………………………………………….

Next of kin Tel No and Name:………………………………………………………………………………………………………………

REGISTRATION DETAILS – OTHER GUESTS

SURNAME                   CHRISTIAN NAME           NATIONALITY        AGE IF UNDER 18

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Twin Room  ………..  Double Room  ………………    Single occupancy room : …………………………………………….

Special Dietary Requests:…………………………………………………………………………………………………………………..

Dietary Allergies: ……………………………………………………………………………………………………………………………….

IMPORTANT MEDICAL INFO: ………………………………………………………………………………………………………….

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GUIDELINE PRICE: £1,125.00 per person  (painter)

£965.00 per person (non painter)

£105.00 single room supplement

Deposit  £250.00 per person per week

NO OF PERSONS TOTAL AMOUNT TRANSFERRED 

(please use your surname as the bank reference)

……………………              £  ……………………….

I confirm that I am authorised to make this booking for all the persons detailed herein & that I/we accept the Company’s Terms & Conditions on page 2 of this form.  All payments are payable to THE FRENCH COUNTRY HOUSE LIMITED  

Credit card payments are accepted from non-EEA residents but incur an additional 3{379dc6b34d4f8ffa30dd2169bfc67eadf0108dfdd134ff056c4824ff6608e7ef} merchant’s fee. 

Debit card payments area accepted from UK residents. 

Sterling bank transfers: Account No. 

Please use your surname as the bank reference.

US dollar bank transfers: Account No.

Please use your surname as the bank reference. 

DECLARATION

I/we declare that I/we have read and agree to the terms and conditions detailed on page 2 of this form.

I declare that I/we understand that a deposit of £250 per guest per week is payable at the booking stage.

I declare that I/we understand that the balance must be paid 8 weeks prior to the commencement of the course.

I/we understand that reservations made within 8 weeks of the start of the holiday – the full amount must be paid.

Signature :…………………………………………… Date:  ……………………..

THE FRENCH COUNTRY HOUSE LIMITED

9 RUE DES FONTAINES

SAINT-ROMAIN-DE-BENET

17600

FRANCE