You can complete the information on this form on screen and then print it out and complete any remaining fields by hand, and post it to us. If you are sending credit card details we recommend that you use our fully secure Online Booking Form. Please make sure you have read our Conditions of Booking.
Before completing and sending to us please check that the boat you require is available by using our Online Availability Check or Contact Us
Please reserve
Monday or Friday Boat
Saturday or Tuesday Boat
or
Please select beds required in the centre cabin for our boats:
Cedar / Maple / Oak
Countess / Empress / Princess
TWIN / DOUBLE (Please delete one)
Starting Day
Date
to
Finishing Day
Date
Cost (pounds sterling) £ (We always check to see you have all the discounts you are entitled to.)
Crew Numbers: Adult Males
Adult Females
Children
Dogs
Is this a Family Group?
I enclose my deposit being one fifth (20%) of the hire fee. Deposit £ or full payment if within 4 weeks.
I wish to make my payment by credit/debit Card Type (We don't accept Diners Card or American Express)
Card Number Issue Date Expiry Date
Issue No. (if appropriate) Security Code (The last 3 numbers on the reverse of your card)
Please tell us if you want the balance of your hire fees to be taken from your credit card four weeks before the start of your holiday. If booking within 4 weeks full payment will automatically be taken.
Name & Address inc Postcode for booking confirmation
Name & Address inc Postcode of cardholder if different
Telephone
Mobile
Email Address
Previous canal experience
If YES Year
Canal
I have hired before from Wyvern Shipping
Year if YES
Other Boating Experience
I was recommended by
NAME if Travel Agent
OR I first saw your advert in
Details if OTHER
Cancellation Scheme Please complete the boxes below if you want to take out our Cancellation Scheme. Do you wish to make use of this service? Remember without this scheme you will be liable to pay the whole hire fee if you cancel and we are unable to re-let your holiday.
Full names of all crew members. Please add ages if under 18 years old. 1
2
3
4
5
6
7
8
9
Cancellation Scheme Premiums - find premium associated with your Total Holiday Cost including deposit.
Up to £400
£20
£401 - £500
£23
£501 - £600
£26
£601- £700
£29
£701 - £800
£32
£801 - £900
£35
£901 - £1000
£38
£1001- £1100
£41
£1101- £1200
£44
£1201 - £1300
£47
£1301 - £1400
£50
£1401- £1500
£53
£1501- £1600
£56
£1601- £1700
£59
£1701 - £1800
£62
For each subsequent £100 add £3 to the premium.
Cancellation Scheme Premium Take from credit card?
I am over 25 years of age and I have read and agree to be bound by your conditions of hire.
Signature:
