Gift certificate amount or package*: ____________________________________________
"To" on gift certificate: ______________________________________________________
"From" on gift certificate: ____________________________________________________
Mail gift certificate to: ______________________________________________________
________________________________________________________________________
________________________________________________________________________
Payment Information
Cardholder's name: _________________________________________________________
Cardholder's postal code: ______________________________
Cardholder's home phone: ____________________ work phone: _____________________
£Visa £Mastercard
Credit card number: ________________________________________________________
Expiration date: _________________ Security pin: ________ (back of card, last 3 digits)
Cardholder's signature: ______________________________________________________
Please fax this form to Le Domaine Bourget at 613-487-2515.
If you have any questions or would like proceed by phone please call us at 1-866-487-3277.
To receive a copy of the receipt, please provide your fax number: ______________________
Thank you for choosing Le Domaine Bourget Inn & Spa.
4105 Bouvier, Bourget, ON, K0A 1E0 Tel: 1-866-487-3277
Fax: 613-487-2515
* Applicable taxes will apply.
If you are purchasing an overnight getaway, your gift certificate
will be made for
2 people or double occupancy unless specified otherwise.
Valid for 1 year from date of purchase.