location

Between the parties and after telephonic agreement or e-mail.

Surname: First name :

Address: .

Phone:

E mail : .

Would like to book

from to

for adults and children

Address of the self - catering accommodation : "AL PICE" Rue d'Ostraux, 8 - 5560 Houyet

Owner's Address

Name : M et Mme TONNEAU-PICOT First name : Carl

Address : Rue Haute Fitombre, 18 - 5101 Loyers (Namur)

Phone : (0032)(0)81 58 03 16

Done at… ,

Signature - Name. ....................................................................

Reservation