Life Changing Break Booking Form

Please fill in as many fields as possible below in order to help us process your booking. Your name and contact details are required. This information will be treated as confidential and will not be passed on to anyone else.

This form is only for booking Life Changing Breaks at Belvedere. If you are looking for Bed & Breakfast accommodation, please complete the Bed & Breakfast Booking Form and for Self-Catering, please complete the Self-Catering Booking Form.

Alternatively you can contact us directly by e-mail: booking@vision-unlimited.co.uk or by telephone: +44 (0)1770 302 397.

Your Contact Details

Your Name:	Required
Address:
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Country:
Telephone:
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Booking Details

Arrival Date:
Number of Nights:
There is no single supplement for our special short breaks.
Number in Party:
Room Type Preferred:
PLEASE NOTE: Belvedere is a non-smoking establishment.

The price shown above includes...

Three-star accommodation.	Choice of breakfast each morning.
4-Course Dinner each evening.	Complimentary drinks throughout.
Complementary Therapy of your choice: Aromatherapy, Hot Stone Massage, Reiki, Reflexology, Hypnotherapy or Craniosacral Therapy.
Swim & Sauna at nearby Spa.	Life Coaching sessions.

Preferred Therapies

Please indicate which of the following complementary therapies you would prefer:

You are advised not to have more than one session on any day.

Aromatherapy

Hot Stone Massage

Reiki

Reflexology

CranioSacral Therapy

Hypnotherapy

Life Changes

During your Life Changing Break you have the opportunity for personal exploration and development. Confidential one-to-one sessions are entirely optional and included in the price. Areas you may elect to explore include:	Changing Career Increasing Self-Confidence Improving Relationships Finding a Partner Clarifying My Purpose
To help you (and us) pinpoint particular issues you may choose to examine during your visit, we invite you to complete our Online Questionnaire although this is entirely optional. This will open in a new window. Your responses will remain confidential.

Special Requirements

Please use the box below to inform us of any special requirements you may have.

Payment Details

We request a £50 deposit per room to confirm your Life Changing Break. However, we will only process this payment if we can accommodate you at the date you have requested.
We accept card payments using VISA, Mastercard, Delta, Maestro and Solo
Debit/Credit Card Number
Valid From
Valid Until
Issue Number
Verification Number	(The last three numbers that appear on the signature strip of your card)

Booking Terms

All bookings are subject to availability and confirmation. By sending this form you authorise us to charge a £50 deposit providing we are able to honour your booking. Once confirmed and acknowledged, we reserve the right to retain this deposit in the event of cancellation. Submission of your debit/credit card details constitutes your acceptance of this and our terms and conditions of booking. If you prefer not to send your card details over the internet we can make alternative arrangements.

I have read and understand these booking terms

Belvedere is the home of VISION unlimited ~ a fresh outlook for life

Life Changing Breaks at Belvedere Guest House