Dates Booked:
________________________________________________
Name of Party Booked: _________________________________________
Home Address of Party Booked ___________________________________
City, State Zip of Party: __________________________________________
Phone and/or Fax Number:_______________________________________
Email Address: (Ours is below) ___________________________________
Referrer: (To whom shall we make the check?)________________________
Contact Name: _______________________________________________
Relation to Booked Party:________________________________________
EIN: ______________________________ (Corporations Only)
Terms and Conditions: 1) This form must
be received completely filled out PRIOR to arrival of guests. 2) Only
one rebate per reservation will be paid - first come, first served. 3)
Century 21 Thomas (our agent) and their employees are not
eligible to participate. 4) Please allow at least six (6) weeks from checkout for funds to
be mailed. (It takes that long before we get copies of the activity and
payment). 5) Offer is void if any damage is found in the unit.
It is agreed that any and all disputes of any nature regarding this offer
shall be decided solely by the Owner. This offer may be canceled at any time
by the owner without notice. Void where prohibited. Our booking agency (Century
21 Thomas) is not responsible for this rebate and cannot answer
questions regarding this rebate. The rebate is managed and paid directly by
the Owner.
Please print and then mail, fax or
email the
above information to:

(You may also send the above via email)
You can also download this form here
in either MSWord or
Adobe PDF