NUMBER OF ADULTS: NUMBER OF CHILDREN:
DURATION OF STAY: ARRIVAL: JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBR NOVEMBER DECEMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2012 2013 DEPARTURE: JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBR NOVEMBER DECEMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2012 2013 TOTAL NIGHTS:
Select Cabin: Black Pine Cabin Fox Fire Cabin
PAYMENT METHOD:
CASH ON ARRIVAL - MUST PRE-PAY 1 NIGHT IN ADVANCE
CHECK IN ADVANCE - CHECK NEEDS TO ARRIVE WEEKS IN ADVANCE OF ARRIVAL DATE
COUPON REDEMPTION
GIFT CERTIFICATE REDEMPTION - PLEASE SELECT THE NUMBER OF DAYS ON THE CERTIFICATE
VEHICLE INFORMATION:
MAKE: MODEL: LICENSE PLATE:
Box #1 - States that Black Pine Cabin Rentals will receive your email address. Black Pine Ent. will not
share your information with any other parties, it is ok to continue.
Box #2 - States that an email is being sent on your behalf. This is a security measure to prevent hacking.
You are NOT BEING HACKED, it is ok to continue. Without continuing your form will not be sent properly.
FOR OFFICE USE ONLY - DO NOT COMPLETE THIS PORTION OF THE FORM
By signing above I agree to all charges mentioned above associated with Black Pine Cabin Rentals. I understand that any damages or charges that may occur during my stay in access to the amount paid above will be charged to me by invoice within 2 weeks of my departure with a full description of the nature of the charges.