Application Form Privacy Policy - We do not release, sell, rent or distribute the information collected. All information collected is for our internal screening purposes only . No information needs to be sent over the Internet, you can print the completed application form and fax / mail it to us. * Required Information (Booking applications without this information will not be processed.)
Cottage Name: * Choose one    the Colonel (2BR. 6 max)     the Major (3BR. 10 max) not available at present	Check-in Date: *
Alternate Choice	Check-out Date: *
Bunkhouse Option     Yes     No	Visa Credit Card No:
Name of Applicant 1: *	Name on Credit Card:
Name of Applicant 2:	Expiry Date on Credit Card:
Address: *
Phone: (home) *	Phone: (work)	Phone: (cell)
E-mail Address	Pets: (please specify, age, breed and weight.) * Pets need special permission and have a surcharge
Licence Plate #   *
Make and Colour of Vehicle *	Maximum # of cars at the cottage during Rental period. *
Names of ALL Adults & Children Occupying the Accommodation Ages are helpful, but not required. * Number of people staying at the cottage including all adults and children. There is no charge for babes-in-arms. *
Booking Information 2012 (All amounts shown are in Canadian dollars) Basic rent for the cottage for the period for 4 or less. Charge includes exclusive parking, dock, patios, paddleboat with lifejackets, canoe, rowboat, BBQ on deck and at waterside, and private access to 4 acres of orchard and meadow. Choose one    $995/wk June 16-Sep 8    $660/wk rest of year    $660/3 night wknd June 16-Sep 8     $440/3 night wknd rest of year     $395/2 night wknd rest of year     Extra charge: Overnight body (over 4). Babe-in-arms no charge.     $100/wk for fifth     $200/wk for fifth & sixth     Extra charge: Pets     $ 60/wk for one     $120/wk for two     Extra option: Linens includes bedding for up to 5 persons- 5 pillows, 5 cases, 5 towels, 5 facecloths, 3 blankets, bedspreads, 6 sheets, 1 tablecloth, 5 dishcloths, 2 dishtowels (39 items)     $60/wk     Extra option: Housecleaning (also charged if cottage not left in the same state of cleanliness in which it was found, incl. no inside garbage)     $80/wk     Provided: Telephone and hi-speed Internet connection.     Long distance charges, if any, are to be paid separately. Phone card for long distance is recommended. excluded     Extra option: Bunkhouse with drinking water, linens, BBQ and fridgette coming summer 2012     $150/wk for one person     $275/wk for two people    Included: 14' aluminum boat/oars and canoe/3 paddles. included 2012     Included: Docking privilege for one's own boat 2012 included 2012     included 2012     Extra option: 15L bottled water. Charge is only for the second bottle.     $0 for use of 1st bottle     $10 for use of 2nd bottle     Extra option: cabin dome tent, sleeps 4 (approx. 9'x 9')     $45/wk     Included: Sterling propane BBQ (tools and 1 propane tank included) A $40 penalty if you leave it uncleaned. included 2012    $25 for extra propane tank.    Extra option: single-size air mattress and foot pump    $ 9/wk for one mattress   $18/wk for two mattresses   Extra charge: garbage in bags/can or bottles left for pickup.     $35 for bags/can     Extra charge: 5 speed mountain bike and helmet     $10/day     $40/week    Total Rent for period (due one month prior to arrival) Plus: Booking Deposit ($250.00CN for Colonel or $1250CN for Major). Due within 3-5 days of booking to secure reservation. Held as a security deposit and returned as $200 in the post unless a portion is needed to cover damage by the guest, long distance phone charges or to cover the Cancellation fee. The $50 is deducted for administrative fee. Date deposit cheque for date of the application. Total Amount Owed in CN Funds Enclosed: I enclose cheque / money order for Booking Deposit (if making application more than 30 days prior to the rental period). Total Amount Owed (if making application within 30 days of the start of rental period). For foreign currency transactions, any unpaid amounts owed or refunds paid will reflect the current rate of exchange and currency exchange charges at the time of payment. Cancellation fee per rental period (applicable only in last 45 days) $200 *Note: Until confirmed by deposit and application, rates are subject to change without notice.
Agreement I ACKNOWLEDGE AND CONFIRM THAT I HAVE READ AND AGREE TO ALL CONDITIONS ON THIS APPLICATION. I acknowledge and agree that this application upon receiving confirmation of acceptance, shall be a binding contract in force between myself and the cottage owner. I agree that I will be responsible for any damages caused by myself or anyone in my party to property or persons. I agree that I will keep the rental cottage and all furniture, chattels, fittings and effects in or about the rental cottage in the same state of repair and condition as at the commencement of the cottage rental and SHALL LEAVE THE COTTAGE IN THE SAME STATE OF CLEANLINESS AND GENERAL ORDER IN WHICH IT WAS FOUND OR THE CURRENT MINIMUM HOUSEKEEPING CHARGE WILL BE DEDUCTED FROM THE BOOKING DEPOSIT. I agree to remove all garbage (including bottles) to the disposal hut. I agree to indemnify and save harmless the cottage owner from any claims during or arising from my use of the cottage. APPLICATION MUST BE SIGNED FOR ACCEPTANCE AND DEPOSIT MUST BE RECEIVED FOR ONE'S WEEK TO BE RESERVED. ____________________________ AND ______________________ Signatures ___________________________________Date Once completed, edit and print the form, sign and fax or forward to G. F. Corke, 14 Claridge., Nepean, ON K2J 4L8. FAX: 613-823-9055 Optional: Click to email the owner of one's intent to rent. E.&E.O. (c) S. A. Corke 2002         Print form