If you have any trouble filling this form online please print it out and fill it by hand and post or fax it.
For the form to work all the items in red and marked with a * must be completed.
www.Getaway-Villas.co.uk

  Title* Full Name* (First Name, Initials, Surname) Age*
Lead driver*


Number of additional drivers
Contact Details:
Address:* Tel/Fax/email  
Home Tel:*
email*
Work Tel.
Fax:
Mob. Tel:
 
Reservation Details:
Vehicle*
Pick-up Date:*
Drop-off Date:*
Pick-up Time:*
Drop-off Time:*
Pick-up Location:*
Drop-off Location:*
 If known....      
Arrival Flight Number Departure Flight Number
 Extras: (we will send you a no-obligation quote if price of ticked item not already agreed. - some of these can be booked later by phone or email)
Child seat x 1 Roof racks    
Child seat x 2 Ski racks Delivery/Collection
           
other requirements/comments/clarification    
Intended method of Payment: (Please DO NOT make any payment yet. Payment will be due once your reservation request has been confirmed by our suppliers.)
Payment Method*
By cheque payable to "Safe Ventures Ltd" and sent to 1 St Chads Drive, Leeds LS6 3PZ, UK
By Bank Transfer to "Safe Ventures Ltd" (account details emailed on request)
By Credit Card (3.5% surcharge) - see link on website.
(click on the appropriate circle)
Declaration: (Please click the box to indicate your agreement)
*
 I confirm that I and my party have read, understood and accept the terms & conditions

 

Before you press the "send" button below you may wish to check the form through (please make sure all the red fields marked with a * are completed - you may need to REDO the WHOLE form if you miss any out). A copy of what is transmitted will be shown to you when you press the "Send Form" button (and we will email you a copy).

Please click on the "Send Form" button for the form to be transmitted to us electronically.