the blue grape
vineyard accommodation

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Request Booking Form

Please fill out the booking form
and fax to this number +61 (8) 8556 4078
or e-mail the information below to
 booking@thebluegrape.com.au

Name : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phone : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dates requested   
arrival- departure :		 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No. of guests : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Length of stay :  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Special requirements : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 Please note this is not a confirmed booking but a requested booking. 
If you would like more immediate info please ring +61 (8) 8556 4078