Breckenridge House

3455 Ringsby Ct. #100 Denver, CO 80216

PHONE: 303.573.0781 FAX:303.573.0224

Please Print and Fax this form for reservations or email us at dbelloni@zeppelinplaces.com

Please make your check payable to the “Breckenridge House”

Breckenridge House

BRECKENRIDGE, COLORADO

RESERVATION REQUEST FROM WEBSITE

Name: _________________________________

Employer: _________________________________

Mailing Address: _________________________________

City, State, Zip Code: _________________________________

Requested Dates: _________________________________

Number of Guests: _________________________________

Home Telephone Number: _________________________________

Employers Telephone Number: _________________________________

Email Address (optional): _________________________________

References (Minimum of two):

1.

2.

Additional Comments:_______________________________________________________

How did you hear about the Breckenridge House? ________________________________________________________________________