LA FERME DE L'HOSTE - WAVRE - BELGIUM

RESERVATION REQUEST FORM

PLEASE USE THE FORM BELOW

===== FIELDS MARKED WITH A * ARE MANDATORY =====

WE WILL QUICKLY REPLY REGARDING THE AVAILABILITY. THANK YOU!

 If you don't receive a reply in the 24 hours, please call us at 00 32 (0)10 23 93 10).

FIRST NAME AND LAST NAME *

STREET ADDRESS *

POSTAL CODE AND CITY *

COUNTRY *

PHONE NUMBER *

MOBILE PHONE NUMBER

EMAIL * (please ensure that the address is correct)

TOTAL NUMBER OF PERSONS
Total number of adults * Total number of children under 12 * Total number of persons *

PLEASE SELECT YOUR ACCOMMODATION

1. GUEST ROOMS
Number of Guest Rooms for 1 person Number of Guest Rooms for 2 persons
Number of Guest Rooms for 3 persons Number of Guest Rooms for 4 persons

2. NUMBER OF WALIBI PACKAGES

Do not forget to check that the park is open on the requested date!
Jolly Jumper 1 night
for adults		 Jolly Jumper 1 night
for children (< 12 years)		 Jolly Jumper 2 nights
for adults		 Jolly Jumper 2 nights
for children (< 12 years)
Calamity Jane 1 night
for adults		 Calamity Jane 1 night
for children (< 12 years)		 Calamity Jane 2 nights
for adults		 Calamity Jane 2 nights
for children (< 12 years)

3. COUNTRY COTTAGES WITH A CAPACITY OF 4 PERSONS
Number of Country Cottages (1 to 3) with a capacity of 4 persons

PLEASE SELECT THE ARRIVAL AND DEPARTURE DATES
ARRIVAL DATE *

DEPARTURE DATE *

DEPOSIT PAYMENT

IMPORTANT: in order to validate a reservation, it is necessary to pay a deposit of 30% and your reservation
will become effective as soon as we confirm it by email (there can be no refund for a cancellation that is
placed less than 1 week prior to the arrival date).

Please select a payment method below *

BY CREDIT CARD

BY BANK TRANSFER
Select a credit card
(Visa - Mastercard - Diners - American)		 Please note our bank details below, so that you can make
the payment in the coming days. Thank you.
Credit card number
(16 digits)		 National bank transfer (from Belgium):
account nr 001-2629051-39
First name and last name
(please enter the full name as shown on the card)
-
-		 International bank transfer (from other countries):
IBAN: BE 13 001262905139
BIC/SWIFT: GE BA BE BB
Name of the bank: Fortis Wavre Centre
Expiration, month and year (example 12/10) NAME: Bernard Debry
CVC (3 last digits on the back of the card) ADDRESS: 101 drève de l'Hostellerie, 1300 Wavre, Belgium

Please note that cheques are not accepted for the payment. Thank you.

YOUR POSSIBLE COMMENTS

PLEASE CLICK BELOW TO SEND THE FORM

WE THANK YOU FOR YOUR VISIT AND WE WILL SEE YOU SOON!

La Ferme de l'Hosté - 101 drève de l'Hostellerie - BE 1300 Wavre - Belgium