Name*       

City            

Address      

Telephone  

E-mail*       

Check-in*    Day  --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31      Month  --- 01 02 03 04 05 06 07 08 09 10 11 12  

Check-out*   Day --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31      Month --- 01 02 03 04 05 06 07 08 09 10 11 12  

Bedroom*     -------------------- single bedroom double bedroom triple bedroom  

Bedroom       -------------------- single bedroom double bedroom triple bedroom  

Bedroom       -------------------- single bedroom double bedroom triple bedroom  

Number of persons*                --- 01 02 03 04 05 06

Children under the age of 4    --- 01 02 03 04         Children from 4 years to 12 years   --- 01 02 03 04  

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