Your Name and Address Name Address County Post code Country Your phone number and email address Telephone Facsimile Email Please reserve accommodation as follows: (click where applicable) Room and Breakfast Dinner, Room and Breakfast Mid Summer Break Carefree Weekend 3-Day Break Covered Garage Required (All rates include Full English Breakfast) Please indicate type of accommodation and room category required Single room Twin room Double room Category 1 Category 2 Category 3 For the Period Arrival date Departure date Number of Children Age of Children Please debit my Access/Visa/Diners Club/American Express Card Number Expiry Date Have you ever stayed at the Hotel Riviera before? Yes No How would you like us to reply to your enquiry? Email Telephone Facsimile Thank you for getting in touch!

Please Note: This form is for Booking Enquiries only, we will confirm within 24 hours whether or not your requirements can be met. If you require any more information, please send us an email.