Print this form on paper and fax to Andorra, fax nº 00376 869 182

Name of the person making the reservation:
 
Last name: 
First name: 
Address: 
Postal code, town and country:
Tel: 
Fax:
E-Mail: 
Language: q English q Spanish q Catalan q French
Comments: 

Information on the hotel:
Hotel chosen: 
Board:         qfull qhalf q  bed & breakfast
Number of rooms: ______ Single(s) ______ Double(s) _____ Triple(s)
Arrival date (dd/mm/yy):          /          /         Departure date (dd/mm/yy):     /     /

Information on Caldea:
 
Name
Programme / module
1st day
(dd/mm/aa)
  Time
Next days
   AM PM
A    
   /     / 
  
q     q
B    
  /     / 
  
q     q
C    
  /     / 
  
q     q
D    
  /     / 
  
q     q
Wellness entrance times: 09:00, 10:30, 12:00, 13:30, 15:00, 16:30.  Main spa: 09:000 to 21:00 but you must specify an entrance time!

"à la carte" treatments to be added:

Person A:  
Person B:  
Person C:  
Person D:  

I shall be paying the obligatory deposit** by:
qCheque  qPostal order*  qBank transfer*        (* fees at my cost and I shall send the receipt by fax or mail)
qwith my international credit card (Visa, Mastercard etc.)
(American express not accepted)
We will only charge your card when we confirm your reservation.  Your card will NOT be charged via internet for security reasons.		 Card number:
       
Expiry date:
   
**50% of the total invoice for reservations with accommodation, 100% of the total invoice for reservations for Caldea only

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