Yes, we would like to book!

'Herdersbrug' at Brugge (Dudzele)

Please complete this form:

	Data (dd/mm/yy)	Number Persons	Number Lunch packs	Number Hot meals (3 courses)
Night of first stay
Night of second stay
Night of third stay

If you wish to stay longer than 3 night then fill in the first night, leave the second open and fill at the third stay the date of your last night. example (22/07/04 - blank - 29/07/04)

Expected arrival time :

If you fail to pay a deposit we may cancel your reservation as from 4 pm.

Owner of a valid International Youth Hostelling membership card with number (*).

Family/Private room. Standard is a dormitory bed booked.

(The number of private/family rooms is limited. Its possible that there are no private rooms available anymore.)

Please fill in the right compounding:

Male		Female
	26 years or older		26 years or older
	under 26 years		under 26 years
	under 12 years		under 12 years
	Children minus 3 years		Children minus 3 years

Please fill in the correct coordinates:

Name

(*)

address

(*)

Zip code

(*)

City

(*)

Country

(*)

E-mail

(*)

Phone

(*)

Fax

(optional)

(*) Compulsary fields

Other remarks:

Name	(*)
address	(*)
Zip code	(*)
City	(*)
Country	(*)
E-mail	(*)
Phone	(*)
Fax	(optional)