39451 Comptche Ukiah Rd
Mendocino, CA 95460
Phone: (707) 937-5570
Email: firstname.lastname@example.org Web Site: www.antiochranch.com
A commitment was made with you verbally. To confirm your reservation, complete and sign this form, then return it with your 50% deposit within 7 days. If you cancel for any reason, call us and we can discuss options.
Please read the Information Sheet carefully!
Name Phone #
Have you been here previously? Yes No Recommended by
Scheduled arrival date: Estimated time
Departure date: Estimated time:
Number of people: Adults Kids Nature of group
House(s): Number of nights of your stay:
11% COUNTY TAX:
Your signature indicates that you have read the Information Sheet, agree to its guidelines, and are committed to your reservation dates.
We look forward to your visit!
Sincerely, Jerry & Pat Westfall
Office Use Only
DEPOSIT (date) (check #) Amount
BALANCE: (date) (check #) Amount