Please select Mrs Miss Mr Name First Name Address Postal Code Town Country Phone: country zone number Fax: country zone number E-Mail
Please book following boat Please select your preferred boat Triton 860 (3/5) Wild 32 (3/5) Aurore 33 (4/6) Espade Concept Fly (5/8) Cruiser (6/8) Classic 1200 (8/12) Eagle (10/12) Period : from till way back one way (1 week minimum) other (please specify, agreed upon during telecon) Please send me a navigation guide at the cost of 25 € (29 € outside EC) : yes no I will hire bicycles at 25 €/bicycle/week (18 € per mini-week or WE) (to be paid upon departure) My team will count persons. Their names, first names and ages (+/- 18 years old) :
Name
First name
Age
Fist name
1
7
2
8
3
9
4
10
5
11
6
12
I will be accompanied by a pet yes no - If yes, which : (no extra cost)
Hiring price (see offer) :
€
Cancellation Insurance (optional but recommended) : 4 % of hiring price :
One-way on Briare/Moret sur Loing - An extra of 90 € :
Navigation guide : 25 € (29 € outside European Community) :
Total
I pay 40% of the total hiring price for reservation, meaning :
I will pay the balance 4 weeks before departure, meaning : OR if payment by credit card, I autorise Charmes Nautiques to cash in the balance 4 weeks before departure
bank cheque post cheque eurocheque holiday cheque credit card :
VISA Mastercard Eurocard Card Number : Security code : (last 3 digits of the number at the back of the credit card) Expiry date :
Date : . . . . . . . . . . . Signature : . . . . . . . . . . . . . . . . . . . . . . .
I recognize having read all the general conditions : I accept them and I pledge to respect them.
Place : . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . Signature : . . . . . . . . . . . . . . . . . . . . . . . . . .
