Application Form

Email:

Full Name:

Present Address:

Home Phone Number:

Office Phone Number:

Cell Phone Number:

Best time to call:

Date and duration of your stay at the "Prana Residence-Spa":

Driver's License:

Make/ Model:

License Plate:

Name, approximate age and relationship of every person that will stay with you include children:
(Prana Residence-Spa is not well suited for children under 7 years of age. However, to accommodate you, we will permit them upon a signed waiver of liability) Maximum occupancy for Prana Residence-Spa is seven* (7). *Please note that 7th bed is actually a mattress in the loft which is in the bedroom with the 2 single beds.
Your Answer

Contact name and number in case of emergency:

Relationship with your contact?:

Pets? (Upon approval):
YesNo

If yes, please describe Breed**, Name, Color, Weight, Age, Sex, Licence Tag and whether crate trained:
(Please include all of the details requested. **Our insurance excludes the following breeds: Pitbull, Rottweiler, Chow, Doberman, Wolf Hybrid, Akita, Bull Mastiff)

To better serve our guests we would appreciate it if you let us know your reason for choosing Prana:

How did you hear about us?:
(Name of referrer or website, ad etc.)

Any Notes or Comments?:

Digital Signature:

Today's Date:

A copy of your responses will be emailed to the address you provided