Bali Villas Holidays

Your Contact Details

Contact e-mail address:

Your name:

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Your postal address:

Town/City:

Province/Country:

Postcode/Zip:

Country:

Telephone number:

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Fax number:

Passenger List

Names of Party:
Please list the names of all your party members.

Title	Initial	Surname	Age

Accommodations

Property Name:

Destination Region:

Destination Resort:

Date of departure:

Date of return:

Length of stay:

Extras Required

Extra Bed Cot High Chair

Any other comments:

Flights

Please arrange for flights from airport.
Accommodation only required, flights arranged independently.

Car Hire

Please arrange a car(s) for pickup & drop off at airport.
Carhire arranged independently.

For a detailed explanation of our carhire please click HERE.

Travel Insurance

Please arrange:

Insurance for		Family (2 Parents and their own Children included)
Insurance for		Adult(s)
Insurance for		Accompanied Children (i.e. friend of family)

Insurance arranged independently with:

For a detailed explanation of our carhire please click HERE.

Your Payment Details

Total value to charge to card
for villa booking deposit

$
A Processing fee of 1.5% will be added to Visa and Master Card Credit card payments

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Expiry date

month / year
e .g: 08/2001
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Issue Number (if Switch card)

Collect Balance when due

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Reservation Forms

Your Contact Details

Passenger List

Accommodations

Flights

Car Hire

Travel Insurance

Your Payment Details