Vermont Country Rentals

Reservation Form

Please fax to 802.867.5713

1) NAME and ADDRESS

Name: ______________________________________________

Address: ____________________________________________

City: ________________ State: ____ ZIP: _____________ Country: _____________

2) CONTACT INFORMATION
Vermont Country Rentals does not give out any personal information to third parties!

Email: ____________________________________________

Phone: __________________ Cell: ___________________

3) PROPERTY and DATES

Choice of property: ________________ Length of stay (# of nights): __________ Rate (per ngt): ____________

Date of Arrival: __________[check-in is at 3PM]

Departure date: __________[check-out is at 10AM]

4) GUEST GROUP INFORMATION

Number of Guests: ______ ( _____ Adults ______ Children under 12)

5) TERMS & CONDITIONS

a). Payment Method:   ¤ Check       ¤ Money Wire       ¤ Credit Card

b) You agree to abide by all of the Rental Policies of Vermont Country Rentals on the policies page. _________ Guest Initials

6) DISCLAIMER:
This property is privately owned. The Owner and Vermont Country Rentals reserve the right to refuse service to anyone at their complete discretion. The Owner and Vermont Country Rentals will not be responsible for accident, injury or for the loss of money, jewelry or valuables of any kind. The property will not be rented to anyone under 21 years of age unless part of or guest of a family group. Please; no large parties. Weddings or gatherings for groups larger than those renting a house are not allowed in our properties without express notification to Vermont Country Rentals.

7) SIGNATURE
I agree to the terms and conditions above:

Signature: ___________________________________            Date: _____________

Thank you for using Vermont Country Rentals. We look forward to welcoming you. If there is anything we can arrange for your stay please contact Vermont Country Rentals.

Email for Reservations            Vermontcountryrentals.com