Hanna Batch

Supporting Families Programme Booking Form


Please complete the following form to confirm your booking request.

Counsellor Details:

Family situation and likely benefits gained from Beach Escape holiday*:

Family Representative:

Postal Address*:
(for booking info pack)
(if available)
Home Phone:
Mobile Phone:
(So we can reach them while on holiday)

Holiday Details:

Holiday house*: Oakura Bay, Beachfront Beach House, 267 Oakura Bay Road
Arrival Date* eg. 06/10/05:
Expected arrival time*:
(You may arrive after 5pm unless prior arrangement made)
Departure Date* eg. 06/10/05:
Expected departure time*:
(You must depart by 12pm unless prior arrangement made)
Number of nights*:
Number of guests: Adults*:
Children (aged 2-17)*:
Baby (under 2years):

Bond Details:

Please provide credit card details for bond purposes. Alternatively, deposit a $500 bond in our bank account which is: 03 0104 0421221 000.

If not providing a credit card number, fill in the credit card number below with all 1′s

Credit Card number*:
Security Code*:
(3 digit code on the back of the card)
Expiry*: Month: Year:
Name on card*:
Select card type*:

Upon receipt of this booking request and the holiday house being available for the dates requested, the bond amount will be debited to your credit card (under the name "Beach Escape Ltd") and the booking will be confirmed via email. You authorise us to charge to your credit card all reasonable costs incurred by us in rectifying any damage to the beach house caused by you or your guests and any additional costs incurred by us for cleaning or phone calls. At the end of the stay, unused bond is credited back to you.

Terms and Conditions

Cancellation: Beach Escape Ltd reserves the right to cancel reservations at any time.

Arrival and departure times: The property will be available from 5pm on the day of your arrival and must be vacated by 12pm on the day of your departure in the event that another guest is arriving that day. If there are no bookings for your departure day, you may leave late with prior arrangement. We are flexible, so let us know your requirements.

Cleaning, linen and food: While many holiday home rentals require you to provide your own linen and towels and to clean the house prior to leaving, we provide you with these services so that you can enjoy a hassle free holiday. Bed linen, kitchen linen and towels are supplied. Our caretaker prepares the house prior to your stay and launders the linen and towels and cleans the beach house after your stay. Please remove all of your remaining perishable food and leave the kitchen and barbeque in a clean and tidy condition. If the beach house requires excessive cleaning after your stay, we reserve the right to charge any additional cleaning costs.

Pets: Pets are not permitted.

Non-smoking indoors policy: There is to be no-smoking indoors and all cigarette butts are to be removed from the property. Breach of this policy will result in a $150 cleaning fee being applied.

Your responsibilities and your liability: You are to take all reasonable care of the holiday house, ancillary buildings and contents during your stay. If the house is left unattended it must be locked. At the end of your stay you are to leave the house and contents in the same condition as when you arrived. This includes returning of all furniture and appliances to where they were when you arrived. Please note that as the family member responsible for the booking you are held responsible for any and all people staying with you at the holiday house including any 3rd party invitees. You will be held legally responsible for any losses, breakages and any damage to the holiday house, its facilities, or amenities that occur during your holiday. Please report any damage or breakage on departure.

Behaviour & respect for neighbours: We make our holiday house available to you for the purposes of having a relaxing family seaside holiday. We do not allow you to use it for loud music and raucous parties and to unreasonably disturb our neighbours. You are to turn stereos off and to retire inside by 11:00pm. Use of fireworks on the section is not permitted. Breach of this policy will result in a $150 disturbance fee being applied, you may have a visit from our local representative and, should the disturbance not be curtailed, you may be required to leave.

Use at your own risk: All the facilities, including the holiday house, garden, bar-be-que, fire, heaters, kitchen appliances, kayaks, boogie boards, kids' toys etc are all made available to you for use at your own risk. Please be careful and supervise children at all times. We will not accept liability for any injury, damage or loss of personal possessions, whether through negligence or otherwise to the maximum permissible by law.

Replacement of goods used: The pantry is usually well stocked with basic supplies (tea, coffee, cooking oil, salt, pepper etc). You may use these during your stay. We ask that you be reasonable and make up for stocks that you use by replacing some depleted stocks to a similar value. Please do not leave any of your perishables (margarine, cheese, milk etc) in the fridge at the end of your stay. If some supplies are running low at the end of your stay, we appreciate you letting us know so we can replenish them for the convenience of our next guests.

If problems arise: We accept no liability should any portion of the holiday house, its facilities and amenities become unavailable to you. Should events arise beyond our control and render the holiday house uninhabitable then we may be forced to cancel the booking. However, should such unusual circumstances arise we will endeavour to offer you an alternative holiday period. You will have no grounds for any claims against us whatsoever. In the event that we become liable to you for loss or damages our liability shall be limited to a maximum of NZ$1,000.00.

Enjoy your holiday: We hope that you have a very enjoyable and memorable holiday with Beach Escape, just like the many who have stayed before you.

Credit card authorization and acceptance of the Terms and Conditions above*

I confirm that I have the authority to provide you with the credit card details.*

Upon receipt of this completed Booking Form we will verify it and email your booking confirmation number.

When submitted a copy of this form (without the credit card details) is emailed to you.