Enquiry Form
Name: Address:
(Please include postcode)
E-mail: *REQUIRED
Telephone:
Arrival Date: Departure Date:
Your 1st Choice: Your 2nd Choice:
Number of Adults:     Number of Children:     Do you require: A Cot?     A Highchair?
Do you wish to bring a dog or other pet?     Breed? (no Rottweilers of Pit Bull Terriers)
How did you hear of East Rose?     (Please give details)
Additional Information:
*Please remember to enter a contact e-mail address in the appropriate box - your form will not be sent to us unless you have done so.