Reservation Request Form
Hi and thanks for choosing Benton Hot Springs Bed and Breakfast. If you have been our guest before, you probably know which room you prefer. Just fill out this form completely and submit it to us. We'll confirm your reservation by email and mail. Again, thanks for selecting to stay with us. We look forward to your visit!
Name:
Date:
E-Mail:
Street Address:
City, State, Zip:
,
Phone:
Cell
Arrival Date:
Departure Date:
Room Preference:
 1st 2nd 3rd
Campground Preference:
 1st 2nd 3rd
Hot Tubs:
 1st 2nd 3rd For those just reserving a tub
Adults in Party:
Children in Party:
Pets:
 Yes No
How did you learn about
our website?
Comments:
Payment Type
 MasterCard Visa American Express
Credit Card number
 Exp:
Name on Credit Card