Name guest 1*

Name guest 2

Name guest 3 (in overleg)

Address*

City*

Country

E-mail address*

Telephone*

Make your choice for extra facilities:

Parking € 2,50 a day

in a locked area no yes

Large bed (240cm) no yes

Babybed no yes

Bicycle rent (€3,75 per bike) no rent 2 bicycles 1 bicycle

Date of arrival*

Date of departure*

Estimated time of arrival unknown 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 9.00 10.00 11.00 12.00 13.00 14.00 15.00 16.00 17.00 18.00 19.00 20.00 21.00 22.00 23.00 24.00

Special remarks

Code*

* obligatory fields