Bed and Breakfast Reservation Form
(Please Complete and Submit Below)
Name
*
(First Name)
(Last Name)
E-mail Address
*
(Used for Communication Purposes Only)
Phone Number
*
(Best Contact Phone Number)
Your Place called Home
*
(What City/Town?)
(Which State/Country?)
Check-in Date
*
-
Month
-
Day
Year
(Arrival anytime after 3:00pm equals first night)
Check-out Date
*
-
Month
-
Day
Year
(Departure day anytime before/by 11:00am)
Number of Nights
*
(Adds automatically based on Check-out Date)
Yellow Bedroom
Please Select
Standard bedroom for 1 person
Standard bedroom for 2 adults
Room has a Queen size bed, private bathroom with hair blow dryer & amenities, free Internet/Wi-Fi, TV with ROKU/Netflix, ceiling fan, AC unit, lockbox, HEPA air purifier, iron & ironing board, luggage rack and emergency equipment.
Green Bedroom
Please Select
Standard bedroom for 1 person
Standard bedroom for 2 adults
Room has a Queen size bed, private bathroom with hair blow dryer & amenities, free Internet/Wi-Fi, TV with ROKU/Netflix, ceiling fan, AC unit, lockbox, HEPA air purifier, iron & ironing board, luggage rack and emergency equipment.
Blue Bedroom
Please Select
Standard bedroom for 1 person
Standard bedroom for 2 adults
Standard bedroom: 1-2 adults and child (6-12 years old) on rollaway bed
Room has a Queen size bed and is big enough to fit a rollaway bed for a child age 6-12, has a private balcony and bathroom with hair blow dryer & amenities, free Internet/Wi-Fi, TV with ROKU/Netflix, ceiling fan, AC unit, lockbox, HEPA air purifier, iron & ironing board, luggage rack and emergency equipment.
How Many in Your Group?
*
(Enter Total Number of People (Adults & Children)
Special Offer: Need a Ride?
Yes Please! - Airport Pickup & Dropoff is available with Manny's Taxi Service. Call (939) 366-2214 (to arrange)
No Thanks - I'll make my own way there
Special Offer: Need West Coast Sightseeing Tours?
Yes Please! - "The West is the Best" Tours are available with Mariex Adventures. Call (954) 347-8601 (in advance)
No Thanks - I have my own trip plans
Any Other Special Request?
(Type any additional assistance above or leave blank)
Choose Your Bedroom Accommodations
*
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Blue Bedroom
(for 1-2 adults)
$
75.00
# of Nights
1
2
3
4
5
6
7
Item subtotal:
$
0.00
Blue Bedroom Rollaway Bed Addition
(for 1-2 adults with child (6-12 years old)
$
10.00
# of Nights
1
2
3
4
5
6
7
Item subtotal:
$
0.00
Green Bedroom
(for 1-2 adults)
$
65.00
# of Nights
1
2
3
4
5
6
7
Item subtotal:
$
0.00
Yellow Bedroom
(for 1-2 adults)
$
65.00
# of Nights
1
2
3
4
5
6
7
Item subtotal:
$
0.00
Cancellation Policy (Select to Acknowledge)
*
Cancellations made 7 days or more in advance will receive a 100% refund. If the above Guest should cancel this reservation within 72 hours or less before scheduled date of arrival, there will be a 50% penalty charge deduction of the total amount paid, excluding tax fee. Any due refund will be credited to the original form of payment within 3-5 business days or as stipulated by the financial institution used.
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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