Number of Guest(*) :

12345

Full name - Guest one (*) :

Home address(*) :

City(*) :

State / Province(*) :

Zip / Postal Code(*) :

Home Telephone Number(*) :

Cellular Telephone Number(*) :

Preferred e-mail address(*) :

Driver’s License state/province and number :

Desired check-in day/time - 4 pm

Desired check-out day/time - 11 am

Date of arrival

Flight # Arrival

Flight Information (Airline) Arrival

Flight Information (Arrival Time)

Date of departure

Flight # Departure

Flight Departure (Airline)

Flight Information (Departure Time)

Unit Requested for Rental

Payment Option

Credit card via Paypal (add 4%)Friends and family transfer via PAYPalBank draft or money orderE-transfer (if CDN)

Number of installments - one

and date Second installment and due date

Final Balance and due date

Emergency and Medical Information (not required but helpful in case of an emergency)

Name of emergency contact :

Emergency contact’s Number

Other medical related information