Simpático Rental Registration Form: Playa La Manzanilla, Nayarit, Municipal of San Blas, Mexico

Andrew A. Stock 
1288 Columbus Ave. #212
San Francisco, CA 94133
USA
Cell:     (415) 999 2639
andrewastock@gmail.com
www.mexicoretreat.net
Guest #1 Name:
 Address:

Guest #2 Name:
 Address:

Guest #3 Name:
 Address:

Daytime Phone Number:
 Evening Phone Number:

Email Address:
  

 
 
Double Occupancy Fees: (checks & transfers) - (Additional persons over age 12: $15/day ea.)
Per week (7 nights)                  $ 550 (pro-rating: 75$ per day)
One month                              $ 1,500

Note: Deduct 25% from June 1 - October 31. A 50% refundable deposit is required when booking. The balance and refundable security deposit of 25% are due 14 days before arrival.

Dates of use:
Beginning Date:
 Ending Date:
Select Date
Select Date


   
Number of Nights:   X Cost of room:    = Total Rent:
Number of Weeks: X Cost per week: = Total Rent:
50% deposit required to hold the dates:
   Deposit:    
25% Security Deposit
(No smoking please)		   Deposit:    


  Total Paid: 
Signature: Please copy and paste the IP Address listed below into the I.P. Address box,
this is for our records so we know you filled out this form.
Name:
Date:
I.P. Address: (Above)

Cleaning or damage costs will be deducted.