Your First and Last Name / Votre nom et prénom

Your Address: Street, City, Country and Zip Code /
Votre Adresse: rue, ville, pays et code postal

Your email address / Votre adresse courrier électronique

Telephone / Téléphone

Fax / Télécopie

Number of people in the group / Nombre de personnes dans le groupe

Dates requested (day/month/year): Saturday - Saturday /
Les dates (jour/mois/année): Du samedi au samedi
Arrive:

Depart:

Other questions or comments /
Autres questions ou commentaires

If children in party please let us know their ages in 'comments'

Liability and Insurance / Assurances

All visitors are recommended to arrange their own holiday insurance, including medical cover as required. The owners can accept no responsibility for accidents. The owners of the The Old Walnut Mill will not accept any liability for any loss, injury or damage of any nature however sustained to or by any person in the course of their occupation of the property and the land belonging adjacent thereto as a result of the occupation of that property or any activity carried out in the course of such occupation however sustained, such activity and occupation are carried out at the individual's own risk.