Kindly complete this form by entering the information starting with the Booking Name field. Please complete each section of the form, email one copy confirming the details of your deposit and print a second copy, sign one and send it to the address below.
Aquela Banda Hotel
Estrada Regional 223 nr. 40
Paul do Mar, 9370-529 Calheta, Madeira, Portugal
Your Details:
Booking Name:
Postal address (including Zip Code/Post Code and Country):
Telephone – home, work, mobile:
Email address:
Passport number and expiry date:
Accommodation booked:
Dates – from/to:
Number of nights:
Number of people in your party:
Booking Cost:
Deposit (30%):
Balance:
Total cost of accommodation:
Your Travel Arrangements:
Flight arrival:
– Departure airport
– Flight number
– Arrival time
Departure:
– Arrival airport
– Flight number
– Departure time
Party Details:
Full names (Mr, Mrs, Miss, Ms, or other title)
(please give ages of children)
Paying for your holiday:
You can pay your deposit, or full amount by bank transfer; and your balance by bank transfer in advance or cash on arrival.
Security deposit – I agree that my credit card can be held as security for the damage deposit. Please provide:
– credit card number
– name as found on your credit card
– address as found on your credit card statement
– CCV number
– Validity dates – from/to
-I authorise Aquela Banda to deduct the appropriate amounts for damage payments (should it be necessary) using the credit card/debit card details set out above.
– Signature
I have read, understood and agree to Aquela Banda’s Booking Terms.
– Signature
– Date
