MPA Homes – Guest Booking Confirmation Form

GUEST DETAILS

Title

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First Name *

Surname *

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Date of Birth *

Nationality *

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Please upload your picture here *

Click or drag a file to this area to upload.

Please only upload .png, .gif, .jpg, .pdf, .jpeg format

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Phone *

Email *

EMERGENCY CONTACTS

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FIRST Person to CONTACT in case of emergency ONLY: Agnès 00 44 742 813 0355

SECOND PERSON *

Phone *

HEALTH AND WELLBEING INFORMATION

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Do you have any medical conditions?

Yes
No

Do you smoke? *

Yes
No

ACCOMMODATION

Are you sharing the room with a friend? *

Yes
No

Company or School Name in the country of destination *

Company or School Address in the country of destination *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

YOUR STAY

You may not yet know the exact dates of your stay? It does not matter! Complete the Guest Booking Confirmation (GBC) with your approximate dates. Once you have purchased your tickets, email us the updated GBC IMMEDIATELY. Upon receipt of the updated GBC, we will send it again to the family with the final dates of your stay.

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Arrival Date and Time in accommodation? *

Date

Time

Place (Airport Name and Terminal, Eurostar, Coach Station, etc.) *

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Departure Date and Time from the accommodation? *

Date

Time

Place (Airport Name and Terminal, Eurostar, Coach Station, etc.) *