Your Contact Details:
(Note - Items in green are
required) ** PLEASE DON'T FORGET YOUR EMAIL ADDRESS |
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| EMail: |
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| Your Name: |
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| Your Address: |
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| City: |
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| State/Province: |
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| Zip/Postcode: |
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| Country: |
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| Phone: |
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| Facsimile: |
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Note: Please include country code and area code in phone and
fax numbers. |
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| Please Book the Following: |
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| Reserve Room: |
Maximum of 2 people per room unless arranged separately.
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| Arrival Date: |
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| Departure Date: |
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| Number of Nights: |
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| No of Adults: |
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| No of Children: |
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| Your Questions, Comments or Special Request:
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| Payment Details: |
Please
refer to our tariff, reservations and cancellation
policies before submitting this booking request.
Please
note your booking request will be guaranteed only
with receipt of your credit card details, and confirmation
of our acceptance of your booking request.
A $25.00 per night deposit will be required at the time of booking.
Please
advise your method of supplying your credit card
details below. You have the choice of using this
secure form or separately by fax or email.
Contact
us for more details
510 Monaghan Road,
Peterborough, ON K9J 5H5
Toll free 866-295-4660 for United States and Canada
All others 705-742-3999
kathy@riversidebandb.ca |
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| For Booking Requests only: |
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Credit Card Details Supplied:
Using This Form
Separate EMail |
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| Credit Card Type: |
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| Credit Card Nameholder: |
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| Credit Card Number: |
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| Credit Card Expiry: |
(MM/YYYY) |
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