Please complete this form and choose one of the following options:

1. Click the submit button -OR-
2. Print the form and fax it to (804) 346-8850, -OR-
3. Print this form and mail it to:
   Club Land’or
   4050 Innslake Drive, Suite 204
   Glen Allen, VA 23060

*Required Fields

Name*:

Member Number*:

Address*:

City*:

State*:

ZIP*:

Telephone*:

Fax:

Email*:

Traveler’s Name:
(if other than Land’or Member)

Travel Dates in order of Preference: (four dates must be provided) mm/dd/yyyy
 

Do you need air travel arrangements?  Yes  No

Note: Friday check-in please. Maximum 4 adults per villa. Children under 12 stay free in same villa as paying adults.

Signature:
(if mailing or faxing)::

_________________________________________________

Would you like a Club Land’or Brochure:  Yes  No

Notes/Requests:

 
Your Initials*:
By initialing here and submitting this form (either through our web site, mail or fax), you hereby acknowledge that you have read and agree to our Terms and Conditions