Address:

Telephone Home:                                       Fax:            

Email:

Arrival date                    Approx. time                   Departure date

Check in time is 3:00 p.m. Check out is 11:00 a.m.

This is a non-smoking vacation rental (failure to comply will forfeit deposit)

$ 150.00 per night # of nights    = $ __________          (3 night minimum)

$ 200.00 Deposit (due within 10 days of making reservation) = $ _________

$ Total Rent (due 30 days prior to arrival) = ____________

Date deposit received                amount $200.00 (45 day cancellation for full refund of deposit)

Date total rent received $          

Please make checks payable to Kauai Wind and Waves or charge by credit card.

Kauai Wind and Waves

P.O. Box 1213 

Kekaha, HI  96752

(808) 635-1791  phone

windandwaves@mac.com  email