Rental Form - Traditional Beach Houses
    Please fill in the rental form below, at the end
       click "Submit", you will return to the Rental Page to complete
       your reservation by sending a deposit according to those instructions.
Thank you and we will see you soon!  You should get a confirmation of this form this evening or in the morning.


When you have checked availability and are ready to RENT A HOUSE, please fill out the following form, you will return to the RENTAL PAGE to complete Step 2.

Thanks and we hope your enjoy your vacation on the Gold Coast.
 

I want to rent the following house according to the rental policy:

Choose the house:


Enter the date of arrival :

-- mm/dd/yy

Enter the date of Departure :

-- mm/dd/yy

How many nights total ?


Enter your time of arrival (for example between 3-4 pm) checkin is available between 3 and 6:30


How many Adults ?


How many Kids over the age of 2 ?


Total number in your party who will occupy house (not counting children 2 and under) ?


Pets, describe each (pet friendly houses only, email with questions) ?


Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail (Please type your address twice)

I am mailing my reservation deposit now (required to hold the house)

Yes No

Enter your full name in the space below to indicate that you have read and agreed to the terms of rental on our central reservation page.


Rates for each house are listed on the house page.  These are the rates that apply.

NOTE:  YOU WILL RECEIVE CONFIRMATION OF THIS FORM THIS EVENING, PLEASE CHECK DATES.


BW.
Copyright © 2003 [Wild Coast Vacations LLC]. All rights reserved.
Revised: 07/11/08