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MADELEIN EN BRIAN VAN ZYL
TEL. & FAX: +27 (0) 14 592 8627 / +27 (0) 82 329 0217 / +27 (0) 82 619 1944 / Email:
rusthaven@telkomsa.net
Please complete this reservation form and click "submit".
If required you can call us on +27 (0) 14 592 8627 or complete this form, print and fax to +27 (0) 14 592 8627.
We will reply as soon as possible to confirm if accommodation is available.
Please provide the following contact information:
Name & Surname
Phone
Fax
E-mail
Information on length of stay:
Arrival
Day
1
2
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6
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8
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10
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31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2009
2010
2011
Departure
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
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20
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25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2009
2010
2011
Information on the room/rooms you require:
Number of rooms required
1
2
3
4
5
6
7
8
9
10
Number of adults
Number of children
Children's ages
(seperate with a comma)
Special Requests