Booking Registration Form - Luxury Gold Coast Holiday Homes

Billing Address*

Street Address Address Line 2 City State Postcode Country

Email*

Phone*

Surname of the booking*

House name for booking*

Arrival Date*

Departure Date*

Number of Adults*

Number of Children

Names of all guests*

Please tell us the name of each guest who will be staying.

Is bed splitting required?

See bedding configuration options on website.

Image Upload*

Please send us a photo or scan of your photo ID.

Accepted file types: jpg, gif, png, pdf, tif, jpeg, Max. file size: 12 MB.

Consent*

I agree to the terms*

By completing this online information form I agree and confirm that I am the indicated person above, all the information supplied is correct and the credit card supplied for the payment is legally mine. I agree to abide by the terms and conditions relating to the letting of this property and agree that my liability for any charges is not waived, I agree to be held personally liable in the event of the indicated person, company or association fails to pay for any part of the full amount of such charges. I agree that I am the card holder of the credit card supplied and am responsible for payment. By completing this form I confirm and authorise acceptability of charges and the terms and conditions relating to the letting of this property. We require in this form a copy of the front and back of your identification (drivers licence or passport) as proof of identity. Payments made by credit card will incur a 2.2% surcharge. I authorise maintenance/housekeeping and contractors access to the property is necessary during my stay.

Name

This field is for validation purposes and should be left unchanged.