Before booking, please contact us to check availability!

Please print, complete, sign  and send to
Peter Evans and Jill Fellows, "Les Peupliers", St Juin, 47400 Lagručre, France


       If you want to email us your booking form, a downloadable Word version of this form can be found here
You can complete this on your computer, save it, and then email it back to us as an attachment

Booking Form

Desired Arrival Date    Length of stay  1 week    2 wks  

Details of all persons in your party

Gender Title Surname Forename Date of Birth
Postal Address for correspondence


Contact phone No.   Email :
Mobile number/s    

 Accommodation / Holiday Cost -  GBP/Euros* 


Deduct 5% for a two week booking


 Total Cost - GBP/Euros* 


Special "Rick Stein Evening" required = Yes / No* :
If "yes" number of people =                                     (payable in cash on arrival)

Declaration :
I declare that, after booking, I will ensure that I and all members of my party have adequate insurance for all eventualities (including medical and accident emergencies, cancellation, travel delays, etc.). On behalf of myself and my party I understand and accept that neither the property owners nor their employees  or representatives will have any liability in this regard. I undertake to pay 25% deposit now and the balance of the cost of my holiday 8 weeks before my/our arrival date. I am aware that if I wish to cancel more than 8 weeks before my arrival date I will lose my deposit and that, should I cancel less than 8 weeks before my arrival date, I will lose the total cost.  I understand that any cancellation must be made in writing. I understand that non-payment of the balance by the due date will also be taken as a formal notice of cancellation. I understand that my booking have to be cancelled by the property owners for any reason then I will receive a full refund (without deduction) and that the property owners will have no further liability. I undertake to abide by the no-smoking rules relating to 'Les Peupliers' as published on the web-site. I declare that I have read and understood the Firm's Terms & Conditions and confirm that I  agree to abide by them. Please accept my booking as detailed above.

I enclose a cheque for the deposit of Ł_________   (25% of the total - payable to "R. Fellows")*
I have made payment of __________ GBP/Euros* by bank transfer*

Name ___________________________  Signed  ______________________  Date_________

* delete items not applicable