| Last Name: | First Name: | MI: |
| Address: | City/State: | ZIP: |
| Home Phone: | Alt. Phone: |
|
Vehicle Make: |
Model: |
Year: |
State: |
|
E-Mail Address: |
Check-In Date: |
Check-Out Date: |
| Number of People: | Number of Pets: | Boat Slips: |
| Rate - Per Night | ||
| + | Extra Person(s) - Per Night | |
| + | Boat Slips - Per Night | |
| + | Pet Charges - Per Night | |
| = | Subtotal - Per Night | |
| * | Number of Nights | |
| = | Before Tax Subtotal | |
| + | Tax @ 8.475% | |
| + | Cleaning Fee | |
| + | Refundable Security Deposit (Deposit equal to one stay) | |
| = | Total Due |
| Signature: | Date: |