Reservation Form

Firstname :
Surname :
Streetname and number :
zipcode :
city :
Home phone :
Mobile phone :
E-mail :
Date of birth :	(dd-mm-yyyy)
desired date of arrival :	(dd-mm-yyyy)
desired departure date :	(dd-mm-yyyy)
type room / apartment :	Dante Alighieri (double room) Donatello (double room) Da Vinci (double room) Rafaël (2-4 person apartment) Michelangelo (2-4 person apartment)
number of adults :
number of children (0 to 3) :
number of children (4 to 10) :
number of children (11 to 16) :
Kitchen package :	None One Two Three
Crib :	None One Two
Baby seat :	None One Two
Safe :	Yes, use the safe.
Questions :
Reason for visit :
Alerted :

Type verification code (image) :