Guest name(s)
E-mail
Address
City
Province/State
Please Select
....................................
AB
BC
MN
NB
NF
NS
NWT
ON
PEI
QC
SK
YK
....................................
AK
AR
AZ
CA
CO
FL
GA
HI
IA
IL
IN
KS
ME
MI
MN
MO
NC
NH
NJ
NV
NY
OH
OK
OR
PA
TN
TX
UT
VA
....................................
Other
Country
Please Select
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Algeria
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Aruba
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Canada
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Chile
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Gambia
Georgia
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Jan Mayen
Japan
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Korea, South
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Laos
Latvia
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Lithuania
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Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
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Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Montserrat
Mozambique
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Nigeria
Norway
Palau
Panama
Papua New Guinea
Paraguay
Peru
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Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Saint Helena
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Sierra Leone
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Slovenia
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Somalia
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Spain
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Sweden
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Syria
Tahiti
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Tonga
Trinidad and Tobago
Tunisia
Turkey
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Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela
Vietnam
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Western Samoa
Yemen
Yugoslavia
Zambia
Zimbabwe
Postal Code/Zip
Telephone
-
Arrival Time
Fax
-
Arrival Date
Number of Guests
Please indicate
....................................
1
2
3
4
5
6
7
8
More than 8
Departure Date
Number of Suites
Please indicate
....................................
1
2
3
4
Preferred Suite(s):
1st. Choice - Suite # 1
....................................
The Rose Suite
The Periwinkle Suite
The Provence Suite
The Wildflower
Alternate Choice - Suite # 1
....................................
The Rose Suite
The Periwinkle Suite
The Provence Suite
The Wildflower
1st. Choice - Suite # 2
....................................
The Rose Suite
The Periwinkle Suite
The Provence Suite
The Wildflower
Alternate Choice - Suite # 2
....................................
The Rose Suite
The Periwinkle Suite
The Provence Suite
The Wildflower
Golf Packages
Spa Packages
Stay n' Play
Golf n' Gourmet
The Ultimate Getaway
The Rejuvenator
The Gourmet Getaway
The Weekend Retreat
Services of Interest:
Meal Reservation at:
....................................
Peninsula Ridge Estate Winery
Pow Wow Restaurant
Vineland Estate Winery
Other
Afternoon Tea
Gourmet Demonstration & Meal
Culinary (Gourmet) Weekends
Wine Tours & Tastings
On-site Food & Wine Seminars
Dinner Theatres
Photographs by Recollections
Spa Services:
Special Occastions:
Select Massage:
....................................
Full Body Massage - RMT
Cranal Sacral Massage
Hot Stone Massage
Indian Head Massage
Pregnancy Massage
Thai Massage
Shiatsu (CTS - Minimum 4)
Special Occassions
....................................
Weddings
Rehearsal Parties
Reunions
Golf Tournaments
Select Other Services:
....................................
Reflexology
Yoga/Meditation
Dinner Theatres
Select Esthetic Services :
....................................
Manicure only
Pedicure only
Manicure & pedicure
Facial
Make-up artistry
Anticipated number of attendees:
Please indicate
....................................
1 - 10 attendees
11 - 20 attendees
21 - 40 attendees
More than 40 attendees
Select Theatre
....................................
20 Valley Playhouse
Shaw Festival
Corporate Events:
Corporate Function
....................................
One Day Meeting
Corporate Retreats
Golf Tournaments
Special Requests/comments:
Allergies:
Dietary Restrictions:
If Yes (please specify)
If Yes (please specify)
How did you find us?
Please select
B&B Canada
Niagara Wine Region B&B Assoc.
Southern Ontario Tourism Org.
Chamber of Commerce
Personal Referral
(By Whom)
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