Please confirm by E mail or telephone, and then print this form and send it with your 100 deposit The balance is payable 6 weeks before the holiday. Cheques should be made payable and sent to:

Mrs. L. Griffiths
Llanfarian, Aberystwyth
Ceredigion, SY23 4EU

You can  fill in the details on your computer before printing - (However if you do not have a printer, please email or post to us the holiday dates required, your name, address, telephone number (and email if you have one) and the names of your group, with the ages of those under 18, Please mention any special requirements - cot, etc )

Name of person making the booking.
Postal Address including Post Code
Telephone Number
Mobile Number
Email Address
 Arrival Date  Departure Date
Names of  all persons in your party, Ages if they are under 18
1. 4.
2. 5.
3. 6.
Baby cot  required   

    please tick if bringing 1 dog

Total Cost as shown on  availability page
Where did you first find out about Blaengader?    

I have read and agree to the Terms and Conditions for renting this Cottage 

Signed Date