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Print and Mail to:                                                     2005 Season
Peter Valorz
109 Huntington Rd
Milton Ma. 02186
Telephone (617) 696-5987

 NAME:___________________________________

TELEPHONE:______________________________

STREET ADDRESS:__________________________

CITY/STATE/ZIP____________________________

E-Mail address    _____________________________

LOCATION:(Please circle one)

     PEQUAWKET POND           CONWAY LAKE

WEEK(S) DESIRED:__________________________

ALTERNATE WEEK(S):_______________________
DEPOSIT                                  BALANCE 
($600/ WEEK): $__________DUE: $_____________ 
(Bank Check Required)
(Add $100 Security deposit on second payment)

I understand that no pets are allowed and agree not to
bring any pets. failure to comply will result in the forfeiture of the security deposit.__________________(please initial)

I understand that it my responsibility to leave the house neat and
clean and bring any trash to the dump, failure to comply will result in the forfeiture of the security deposit. ____________(please initial)

A security deposit of $100 is required as part of the second payment. The security deposit will be returned within four weeks after your vacation provided the house is left clean, in good repair and the trash has been removed.

Weekly rentals are from Sunday 2pm  to Sunday 11am.