Silversands
Family Resort

RR #1 Kearney, Ontario P0A 1M0
      (705)636-5380         Fax: (705)636-5380

silversands@cottagecountry.net

Reservation Form

Name: __________________________________________________

Address:  ________________________________________________

Phone:  __________________________________________________

Accommodation Requested:  __________________________________

Number in Party: (please state the number of adults and children under 16)  ____________

Arrival Date:  ______________________________________________

Deposit (33%):  ____________________________________________

Comments:  _____________________________________________________________

Visa Number & Expiry Date:   __________________________________

Signature:  ________________________________________________

Date:  ___________________________________________________

Your hosts are:  Mark & Elizabeth Demain