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Secure Reservation Form
Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
*E-Mail:
Billing Information
*First Name:Same name as on your card
*Last Name:
*Street and number:Where your statement is mailed
*City:Town
*State/Country:
*Zip Code:
*Phone:
Deposit/credit card Information
*Way to pay :we email you the invoice
*Card Number:No dashes or spaces please
*Expiration Month:From your card
*Expiration Year:From your card
*Card Brand:
*CVV2:3 digits (back of card-right)
*Pay in :
*Deposit amount US$ :20% of total
*Deposit amount EUR :20% of total
*Deposit amount ILS :20% of total
Rental information
*Apartment number:
1
2
3
4
5
6
one form for each apt.
*Check in date:
*Check out date:
Check in at 14:00- change to:if possible
*Leaving date:
Check out at 11:00- change to:if possible
*Number of person:including children
*Rent total amount US$ : As qouted (for all period)
*Rent total amount EUR : As qouted (for all period)
*Rent total amount ILS : As qouted (for all period)
*Rest of payment :Total payment minus deposit
*Rest of payment ILS :Total payment minus deposit
*Rest of payment :Total payment minus deposit
Balance will be paid by cash or credit card until 3 days before leaving
*Need car parking?
Yes
No
If available
Want an Israeli prepaid cell phone?
Yes
No
If available
want a regular line phone?
Yes
No
If available
Need a crib for baby?
Yes
No
Comments:Special request
Short term rental agreement
Checkout : Renter will return the keys to landlord . For lost key renter will pay $75 (replacing the lock expenses)
Indemnification: Renter releases landlord from liability for and agrees to indemnify landlord against losses , incured by landlord as a result of (a) Renter`s failure to fulfill any condition of this agreement; (b)any damage or injury happening in or about rental or premises to renter`s invitees or licensees or such person`s property; (c)Renter`s failure to comply with any requirements imposed by any govermental authority; (d) any judgment ,lien, or other encumbrance filed against renter as a result of renter`s action.
Entire agreement:This agreement and any attached addendum constitute the entire agreement between the parties and no oral statements shall be binding . It is the intention of the parties herein that if any of the rental agreement is invalid, for any reason,such invalidity shall not void the remainder of the rental agreement.
Failiure of landlord to insist upon compliance with the terms of this agreement shall not constitute a waiver of any violation.
Renter
I have read the foregoing agreement and by marking ``I agree`` and submitting this form, I agree to its terms (as if I sign it).
*I agree
Please note: The apartment is reserved for you only after we charge your deposit and email you receipt and confirmation.
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