RESERVATION FORM
Thank you for submitting the following information:

Family name
 First name
Adress
 City
Prov./State
 Postal Code
 Country
Phone Home:
Office:
Cellular:
E-mail:

 

Room Type

Room L'Escale (Queen size bed + Hide-a-bed)

Room L'Évasion (Queen size bed)

Room L'Envolée (Double size bed)

Room L'Échappée (Twins beds)

Room L'Échappée (King size bed)

 

Package type


Lodging
Tentation
Romantic 1 night
Romantic 2 nights
Escapade

Evasion
Of Dream
5 days package
7 days package

Arrival date
(JJ/MM/AA)
 Departure date
(JJ/MM/AA)
 No of nights

 

No of people

Adult (s)

Child (s)

Child years old

Additional informations
*LET US KNOW AT WHAT TIME (6H00Pm TO 7H30Pm) AND DAY YOU WOULD LIKE TO HAVE YOUR FIRST DINNER (THE HOUR WILL BE CONFIRM)*


Credit card number
Expiration date
  MM/AA
Visa MasterCard

Auberge / Restaurant
La Belle Escapade
562, Chemin Kwnolton
Lac Brome, (Québec)
J0E 1V0

Phone: 450-243-5532

E-mail: info@belleescapade.com