Please state the number of adults   ___________ number of children  _____________ages_______________.


Please note that in accordance with Smoking regulations we request that you smoke outside – ashtrays are provided


I hereby acknowledge that I am liable for the payment in full.


I hereby agree that the owner shall not be responsible for loss, damage or injury to any property or person brought by me/us upon the property or person, whether arising from fire, theft or from any other cause, and by the negligence (gross or otherwise)or wrongful act of any person in the employ of the owner. I agree to report and make good on any breakages/damages and leave the premises in order. I undertake that should smoking in any rooms occupied by me or any in my party be detected, I will be liable for as R1000 per room special cleaning charge.


Please indicate any special dietary requirements.



To avoid any misunderstanding, a booking constitutes a binding contract. We will seek compensation for cancelled that cannot be re-let, including premature curtailment.


Accommodation will automatically be cancelled if the deposit is not received within 3 days.


Deposits are not refundable in the event of non-arrival.


No persons other than those mentioned above may use or share the accommodation.


Day visitors will be allowed on request and will be a limited number.


Day visitors must be entertained downstairs and will be able to make use of the honesty bar facility which includes teas and coffees.


The terms and conditions of the booking are deemed to be accepted on signature of this form.



NAME AND SURNAME MAIN GUEST ____________________________________________________



ID NUMBER ________________________________________


 SIGNATURE _________________________________________

For the family /group booked in my me.



Date _______________________________________________________


(Form can be requested on premises)