Waiting List

Name* First Last
Address*
Street Address Address Line2 City State / Provice / Region Postal / Zip Code Country
Phone Number
Email*
Stay Dates

Fill with information of the days that you wish to stay at Casa Kimberley.
Our waiting list dates are between November 2010 and June 2011.

Thank you.
* Day Month Year No. of Nights
Day Month Year No. of Nights
Day Month Year No. of Nights
Comment
I wish to receive information about Casa Kimberley.
Do Not Fill This Out