Indemnity Form for Country Lane Guest House

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Particulars and Indemnity

Email *

Name *

I D Number *

Cell Number *

Vehicle Registration Number *

If having breakfast, please complete the below by ticking what you would like: (Eggs are fried and menu is a set menu, please ask for other options under options) *

Select if you are not having Breakfast

Eggs (Please select one below for eggs)

Hard

Medium

Soft

Bacon

Pork Sausage

Grilled Tomato

White Toast

Brown Toast

Other:

Required

Dinner Restrictions, if you are having dinner (please let us know if you have any eg. something you don't eat)

Please Tick if applicable and describe under Other *

None

Vegetarian

Allergies

Other:

Notes

Breakfast is served between 6:45 - 8:15, Earlier by prior arrangement. Please advise if there is a change of time.
Payment is required in full upon arrival, by Card, Cash or Zapper (Unless a Holding Deposit was paid)
Please note: The undersigned is ultimately responsible for payment,even if booked by guests employer.
Check out time is 10:00, later by prior arrangement.
The management and staff are committed to providing the best accommodation standard that we are able; but cannot
be held responsible for any loss or damage while on the property of Country Lane.
Please help us Maintain our standards by reporting any problem encountered during your stay.
We are available 24 hours a day.

Comments and/or questions

A copy of your responses will be emailed to the address you provided.

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