*Please print this form, complete it and mail to the owners at the address below.
Booking Form						US $	GBP £
Hideaway at Terra Verde, Kissimmee, Florida					Price Quoted:
					Pool Heat/Cleaning Fees:
Mail or Fax To:	Heather & Kevin Blackburn				13% Florida Sales Tax:
	1508 Huntfield Way				Refundable Security Deposit:	$250.00	£150.00
	Jarrettsville, MD 21084				Total:
	410-916-2254		Fax: 267-948-5003		Less Deposit Received:
	info@hideawaybeachlane.com				Balance Due:
Please complete the following information:					Deposit is due at time of booking. Final Balance is due 4 weeks prior to your arrival. Security Deposit will be refunded within 2 weeks following your departure.
Name:
Address:
					Please let us know if you have any special requirements or requests:
Zip/Postal Code:
Phone:
Mobile:
E-mail:
Arrival Date:
Departure Date:					How did you hear about Hideaway at Terra Verde?
Number of nights:
Payment Method:	o Check		* Complete below if paying by credit card:
	o Money Order		Name on Credit Card:
	o VISA		Credit Card Number:
	o MasterCardrd		Expiration:
			Signature:
Please list the names of all members of your party. Please include the ages of all children under 18.
	Name / Age				Name / Age
1				9
2				10
3				11
4				12
5				13
6				14
7				15
8				16
o I understand and agree to your Terms and Conditions ( www.hideawaybeachlane.com/terms.html )
	Please sign here: