NAME____________________________________________
ADDRESS_________________________________________
CITY___________________ STATE_________ ZIP________
PHONE--HOME_________________WORK_____________________
EMAIL________________________FAX______________________
OCCUPATION________________EMPLOYER ________________

1. The HOUSE (located at 82-6284 Pu'uhonua Rd. Captain Cook Hi. 96704) shall be rented to the undersigned for the following:

DATES: ARRIVAL_______Flight arrival time?_______DEPARTURE_______
For a total of ______Nights: (check-in 3 PM. check-out 10 AM --Unless otherwise arranged)

RATES:
$____________ RENT for # of people______ (based on weekly or nightly rate of _____________ ).
_____________ HAWAII STATE TAX
_____________ Deposit-Refundable less cleaning/damage
$____________TOTAL
_____________ ALREADY PAID date:_______how__________
$____________BALANCE: due date_______________

How will you pay your balance? (Check one)

Credit Card___ If so, #: ______________________________ Or
Master or Visa_______Exp Date:_______ Zip Code______ Check ___

2. The phone # for the vacation home is 1-808-328-9955. All long distance calls to be charged to calling card or collect.
3. The property(including contents) shall be the responsibility of the undersigned.
4. Balance of security deposit will be returned 30 days after departure.
5. Cancellation Policy: Prior to 90 days before arrival--full refund less 15%.
Less than 90 days before arrival: Refund based on ability to rebook.

SIGNATURE:____________________________DATE________________________

email: info@kbayhawaii.com