Application Form Privacy Policy - We do not release, sell, rent or distribute the information collected. All information collected is for our internal screening purposes only . No information needs to be sent over the Internet, you can print the completed application form and fax / mail it to us. * Required Information (Booking applications without this information will not be processed.)
Property Name: *	Check-in Date: *
Alternate Choice	Check-out Date: *
Garage Option     Yes     No	Visa Credit Card No:
Name of Applicant 1: *	Name on Credit Card:
Name of Applicant 2:	Expiry Date on Credit Card:
No. of years at present Address: *	Length of Employment: *
Rent/Own Home? *	Job Title: *
Address: *	Employers Name and Address: *
Phone: (home) *	Phone: (work)
E-mail Address	Pets: (please specify, age, breed and weight.) * Pets need special permission and have a surcharge
Home Insurance Provider: *	Policy Number: *
Licence Plate #   *	Drivers Licence #  *
Make and Colour of Vehicle *	Maximum # of cars at the house during Rental period. *
Names of ALL Adults & Children Occupying the Accommodation Please include Ages of ALL People. * Number of people staying at the house including all adults and children *
Booking Information 2003 (All amounts shown are in Canadian dollars) Basic rent for the house for the period ($613/ wk/ 4 people..special. $77/night/person (minimum of 2 nights or 2 people). Extra options can accommodate up to six persons.) Choose one    $613/wk max. introductory offer   $154 - 1 person, up to 2 nights    $231 - 1 person, 3 nights    $308 - 1 person, 4 nights    $385 - 1 person, 5 nights    $462 - 1 person, 6 nights    $154 - 2 people, 1 night    $308 - 2 people, 2 nights    $462 - 2 people, 3 nights    $613 - 2 people, 4 nights    $231 - 3 people, 1 night    $462 - 3 people, 2 nights    $613 - 3 people, 3 nights    $308 - 4 people, 1 night    $613 - 4 people, 2 nights    $613 - 3-4 people, 3-6 nights    Extra charge: Overnight body (over 4)    $100/wk for one    $200/wk for two    $300/wk for three    $400/wk for four    Extra option: Pets    $ 60/wk for one    $120/wk for two    $180/wk for three    $240/wk for four    $300/wk for five    $360/wk for six    Extra option: Linens includes pillow(s), case(s), towel(s), facecloth(s), blanket(s), bedspread(s), sheet(s). Plus for the kitchen tablecloth, dishcloth(s), dishtowel(s). Extras are supplied based on length of stay.    $ 8/wk for one bed    $16/wk for two beds    $24/wk for three beds    $32/wk for four beds    Extra option: Housekeeping (also charged if house not left in the same state of cleanliness in which it was found)    $75/wk    Extra option: 3 pce picnic thermos    $10/wk    Extra option: Garage storage privilege of one's own boat in locked garage    $60/wk    Extra option: inflatable dinghy with pump and 2 oars    $60/wk    Extra option: 18L bottled water dispensed from a water cooler    $18 each    Extra option: cabin dome tent, sleeps 4 (approx. 9'x 9')    $50/wk    Extra option: deluxe propane BBQ (tools and 1 propane tank included)    $38/wk    $68/wk with 2nd tank    Extra option: air mattress and foot pump    $ 9/wk for one mattress   $18/wk for two mattresses   $27/wk for three mattresses   $36/wk for four mattresses   Extra option: sleeping bag freshly laundered    $ 4/wk for one sleeping bag    $ 8/wk for two sleeping bags    $12/wk for three sleeping bags    $16/wk for four sleeping bags    Extra charge: garbage more than a full garbage can    $ 5 for one green bag    $10 for two green bags    $15 for three green bags    $20 for four green bags    Total Rent for period Plus: Booking Deposit ($250.00 / week / house) (Held as a security deposit and returned in full in the post within two weeks of departure unless a portion is needed to cover damage by the guest or to cover the Cancellation fee.) Total Amount Owed Enclosed: I enclose cheque / money order for: (Booking Deposit if making application more than 30 days prior to the rental period, Total Amount Owed if making application within 30 days of the start of rental period) in CN Funds. (For currency conversion please use this webpage. Any bank fees will be deducted from the Security Deposit refund. Sorry.) Cancellation fee per rental period (applicable only in last 30 days) $160
Agreement I ACKNOWLEDGE AND CONFIRM THAT I HAVE READ AND AGREE TO ALL CONDITIONS ON THIS APPLICATION. I acknowledge and agree that this application upon receiving confirmation of acceptance, shall be a binding contract in force between myself and the house owner. I agree that I will be responsible for any damages caused by myself or anyone in my party to property or persons. I agree that I will keep the rental house and all furniture, chattels, fittings and effects in or about the rental house in the same state of repair and condition as at the commencement of the house rental and SHALL LEAVE THE HOUSE IN THE SAME STATE OF CLEANLINESS AND GENERAL ORDER IN WHICH IT WAS FOUND OR THE CURRENT MINIMUM HOUSEKEEPING CHARGE WILL BE DEDUCTED FROM THE BOOKING DEPOSIT. I agree to remove all garbage (including bottles) to the disposal hut. I agree to indemnify and save harmless the house owner from any claims during or arising from my use of the house. APPLICATION MUST BE SIGNED FOR ACCEPTANCE AND DEPOSIT MUST BE RECEIVED FOR ONE'S WEEK TO BE RESERVED. ____________________________ AND ______________________ Signatures ___________________________________Date Once completed, edit and print the form, sign and fax or forward to S. A. Corke, 14 Claridge., Nepean, ON K2J 4L8. FAX: 613-823-9055 Optional: Click to email the owner of one's intent to rent. E.&E.O. © S. A. Corke 2002         Print form