All fields required unless otherwise indicated. Please note this form is for a request for reservation and does not mean a room is available and put on hold - a credit card (Visa or MasterCard) must be provided (via email or phone call) to confirm the reservation (if there is availability). Thank you.
PLEASE NOTE: THIS IS NOT A SECURE SERVER. THIS PORTION IS OPTIONAL! This information is needed to confirm your reservation with us. However, you may leave it blank and refer below for other ways to submit this information.
OPTION 2: Complete this form, without Credit Card Information, submit it to us online, then call or fax the Credit Card Information to us. Toll-free: 1-866-543-7736, Fax: 1-519-236-7505
OPTION 3: Print the fully completed form and mail or fax it to us. Hessenland Country Inn, RR#2 Zurich ON N0M 2T0, Canada