Reservations - Blaeberry Mountain Lodge -test

ON-LINE RESERVATION FORM

Please provide the following information:

Full Name

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Telephone
(include area code)

FAX
(include area code)

E-mail

(please double check it!)

Payment Method:

(We will take your Credit Card number over the phone when we confirm your reservation)

Which type of accommodations would you like? (if available)

# of Adults:

# of Children:

Meals Included?

Yes No

Dates Requested

Arrive:

Date Year

Depart:

Date Year

Have you visited with us before?

Yes No

How did you find us?

Adventure Itinerary List - We can prepare adventure packages for you...Choose which activities you'd like us to arrange for you:
Air Tours	Bird Watching	Horseback Riding
Cross Country Skiing	Hiking	Biking Tours
Mountain Biking	Whitewater Rafting	Downhill Skiing/ Boarding
Heli-Skiing
	Other

Additional Comments or Requests:

Blaeberry Mountain Lodge

Your Hosts: Rainer Grund and Renate Polzer
Address: 1680 Moberly School Road, Golden, B.C. Canada V0A1H1	Phone/Fax: 1-250-3445296
E-Mail: info@blaeberrymountainlodge.bc.ca