Newton Lake Vacation Rentals and Lodgings Rental Application Agreement Name: ______________________________________________________________ Address:____________________________________________________________ ____________________________________________________________________ Phone(Home):____________Phone(Work):_____________Fax:_______________ E-Mail:__________________________ Dates(Arrive):____________________Time:_____________________ Dates(Depart):____________________Time:_____________________ Rental House: Lodge_______________Manor_____________________ Amount of People: Adults________Children_________ Special Requirements_____________________________ References with phone #: 1._______________________________________________________ 2._______________________________________________________ Check#______ Total Amount: ________ Security Deposit Amount:_________ Or PayPal Transactions ID Number:__________ Security Deposit is required to secure dates and ensure against damage. The total amount listed above will be due on arrival. The security deposit will be returned after inspection of premises on departure. Since we are a small business our cancellation policy is any cancellation with 30 days or less notice will forfeit the deposit unless we are able to re-book the vacancy. Any damage done to the property during the time frame listed above will be the responsibility of the persons listed on this agreement. The above persons will also be responsible for phone charges made during the time frame of the stay. For insurance purposes we ask that the amount of people does not exceed the amount listed per each house. Please put your license number on your Check Deposit. Signature:________________________________________________ Please make checks payable to: Noreene Carney/Newton Manor Newton Lake Vacation Rentals and Lodgings 151 Shadyside Drive, Newton Lake Greenfield Twp., Pa. 18407 Phone: 570-222-9369 Phone/Fax: 570-222-3622 E-Mail: RentalInfo@Newton-Lake.com Web Page: www.newton-lake.com Help us improve our advertising efforts. Please tell us how you heard of us. Referred by: person________Website_______Advertisement______Brochure________