This is only a request form. We'll need to confirm your request and availability before it becomes definitive.
To be able to answer your request we need your full contact details.
PLease do not forget to provide a working email address, number of persons, desired room and date of arrival and departure.

 Title  First Name  Last Name
 Postal code  City
 State  Country
Telephone number
Room you would like

The Wells' room - La Chambre du puits
L'étage (the floor)
The appartment
The Yard Room

Number of adults
Number of children
Please provide ages in remark
Date of arrival
Date of departure

I would like 'table de hôte' (dinner)