Registration

To reserve your weekend at the Cottage, please fill out and submit the form below. A $100 non-refundable deposit is required with your reservation. PayPal offers a secure on-line payment method. All information will be kept strictly confidential.

First Name:
Last Name:

Address:
City:
State:
Zip:
Phone:
Email:
Pay By Check:
Pay By Credit Card:

Weekend Desired:
How did you hear about us:

We accept:

If paying by check or money order

Please print out this form and remit a $100 non-refundable deposit to:

P.O. Box 493 Wayne, IL 60184

Final Payment

Final payment is due 30 days prior to your reserved weekend. If balance is not paid by due date, reservation will be cancelled and deposit will be forfeited.

Cancellation

Deposits may be transferred to another weekend if cancellation is made with at least 30 days notice.