Florida Palms - Booking Form

Florida Palms - Booking Form
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province / County

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail*
Number of Guests*
Name of guests (include age if under 16 please)
Guest 1
Guest 2
Guest 3
Guest 4
Guest 5
Guest 6
Guest 7
Guest 8
Arrival Date*

MonthDayYear
Departure Date*

MonthDayYear
Number of Nights*
Do you require Pool Heat?*
Payment Details
Currency
Pool Heat Price*
Base Price of Stay*
Refundable Bond*
Sub Total
Payment Method
Grand Total
Amount Sending Today (Deposit / Bond / Full Amount)*
Remaining balance to pay (8 weeks before travel)
Please confirm that you have read and agree to the Terms & Conditions as stated in the Booking Agreement*

I confirm
Once a form has been submitted we will contact you via E-Mail. Thank You
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