RESERVATION FORM

1. INSTRUCTIONS

To reserve The Aviary, please return this Reservation Form and $150 reservation deposit (non-refundable) to:

Judith Wallick, Fairview Farm, 161 Kinsman Road, Grafton, NH 03240.
Fax: (603) 523-9240. E-mail: jwallick@together.net

If booking within 4 weeks of arrival, full rental fee and security deposit are due with this reservation. For refunds, see CANCELLATION POLICY.

2. NAME and ADDRESS

Name: ______________________________________________
Address: ____________________________________________
Address: ____________________________________________
City: ________________ State: ____ ZIP: _____________

3. CONTACT INFORMATION

Email: ____________________________________________
Phone (AM): _______________ Phone (PM): ______________
Cell: ___________________

4. DATES

Length of stay (# of nights): __________
Date of arrival: _________________________[check-in 3PM]
Departure date: _______________________[check-out 10AM]

5. GUEST GROUP INFORMATION

# in party: ______ Adults: ____ Children & Ages: __________
Please list last names of all adults in party: _____________________________
________________________________________________________________

6. TERMS & CONDITIONS

a. Payment:

i. Call 603 523-4277 for credit card processing.

ii. Money wires to (*make sure to include our Account Name):
ABA# 011600570
Account # 5240458994
Account Name: Judith L. Wallick

iii. Or send checks to:

Judith Wallick, Fairview Farm, 161 Kinsman Road, Grafton, NH 03240.

b. All Vermont rentals less than 31 days are subject to a 9% Vermont Rooms Tax.

c. The Security Deposit is not included in the rental fee amount. It is a separate deposit, usually equal to one night's stay and is processed through your credit card. The Security deposit is due with the full rental fee.

d. You agree to abide by all of the Rental Policies of The Aviary.

7. DISCLAIMER

This property is privately owned. The Owner reserves the right to refuse service to anyone at their complete discretion. The Owner will not be responsible for accident, injury or for the loss of money, jewelry or valuables of any kind. The property will not be rented to anyone under 21 years of age unless part of or guest of a family group. Please; no large parties. Weddings or gatherings for groups larger than those renting a house are not allowed without express notification to the Owner.

8. SIGNATURE

I agree to the terms and conditions above:

Signed: ________________________________________Dated: _________