Title :

Last Name :

First Name :

Address :

Zip code :

Phone:

City :

Fax:

Country :

Email :

Nbr. Adult(s)

Nbr. child(ren)

Age :

Room - shower - large bed :

Eurocard/Mastercard Visa American_Express

To guarantee your booking we need your credit card number. Note that these information are not kept confidential and immediately unobtrusive so no booking is made. It is there about a guarantee: if you don't come and didn't annul, the penalty is of one night for the reserved room. You can annul this booking 48h before your date of arrival, without penalty.

This form passes in transit by internet. If you don't wish to communicate your number of credit card by this means, print this page and fax there to the: +33.(0)1.40.50.81.21