Port Mouton Bay Cottages

      

"the cottages by the  sea"

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Registration Form
             Contact Information:                                                           Reservation Information:

Name*:
Address*:
Address 2:
City*:
State or Province*:
ZIP or Postal Code*:
Country*:
Phone*:
Email*:

Number of Adults*:
Number of Children*:
Total Registering*:
Date Needed*:
Weeks Required*:
Nights Required*:

Method of Payment*:
Name on Card*:
Credit Card Number*:
Expiry Date (mm/yy)*:

Type of Accommodation:

Payment Information:

Note: * means a required field.

Additional Information Request:
Please outline any additional information, queries or comments in the space provided below:

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Completing this form does not constitute a confirmed reservation. No reservation is deemed confirmed until you have received a confirmation booking number which will be within a maximum 72 hours of receipt of this reservation request (usually within 48 hours).