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2021 Booking Application Form

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Phone 613-825-7838 / Fax 613-823-9055



Step 1. Fill in the booking Application Form below.
Step 2. Print the Application to Hard Copy or File.
Step 3. Sign the Application if wish to fax.
Step 4a. Fax Application as an attachment. (fax # and address appear at bottom of application).
OR Step 4b. Click on the Submit button at the bottom of the form which invokes a digital signature.

Application Form
Privacy Policy - We do not release, sell, rent or distribute the information collected. All information collected is for our internal screening purposes only .
No unencrypted information needs to be sent over the Internet, you can print the
completed application form and fax / mail / email it to us. If mailed or faxed it must be signed

* Required Information (Booking applications without this information will not be processed.)

Booking Information 2021
(All amounts shown are in Canadian dollars)
Check-in Date: *
Check-out Date: *
Bunkhouse Option
Name of Applicant 1: *
Name of Applicant 2:
Name of any other Applicant:
Address: *
Phone: (home) *
Phone: (work)
Phone: (cell)
E-mail Addresses
Pets: (please specify, age, breed and weight.) *
Licence Plate Nos. #   *

Make and Colour of Vehicles *
Maximum # of cars at the cottage
during Rental period. *

Names of ALL Adult & Children Occupants Ages are helpful, but not required.
For reasons, list visitors, car licence numbers and boats in the box below.

Number of people staying at the cottage including all adults and children. There is no charge for babes-in-arms.Maximum accomodation, without special arrangements with the lessor, is six.
Four persons in the cottage and two persons in the bunki! *

Basic rent for the cottage for the period for 4 or less. Charge includes exclusive parking, dock, patios, paddleboat with lifejackets, canoe, rowboat, BBQ on deck and at waterside, and private access to 3 acres of meadow and cottage lot.
Extra charge: Overnight body (over 4) Babe-in-arms no charge.
Overnight guest (max 1) is $25/night. Overnight guest must be declared.
Extra charge: Extra night for cottage
Extra charge: Pets
Extra option: Linens
includes bedding for up to 5 persons- 5 pillows, 5 cases, 5 towels, 5 facecloths, 3 blankets, bedspreads, 6 sheets, 1 tablecloth, 5 dishcloths, 2 dishtowels (39 items)
Mandatory option: Covid-19 Cleanup Premium
Provided: Telephone for emergency and hi-speed Internet connection nearby.     Long distance charges, if any, are to be paid separately. Phone card for long distance is recommended.
Extra option: Bunkhouse with drinking water two twin-size beds/mattresses/duvets/pillows.
Extra option: 15L bottled water. Charge is only for the second or more bottles.
Extra option: Paddle Boat, $140 weekly
Included: Sterling and Huntington propane BBQ's
(tools and 2 propane tanks included)
A $40 penalty per BBQ if you leave it uncleaned.
Extra charge: garbage in bags/can or bottles left behind at departure. Thur AM pickup of garbage by locals is no charge.
Select the number of weeks you wish to book!
Total Weekly Rent
Total Rent for the booking period
Booking Deposit
($250.00 Cdn for cottage). Due within 3-5 days of booking to secure reservation. Held as a security deposit and returned as $200 within 7 days of departure unless a portion is needed to cover damage by the guest, long distance phone charges or to cover the Cancellation fee. The $50 deduction covers admin costs. Date deposit cheque for date of the application.
Total Amount Due Including Deposit Paid in Cdn Funds You are responsible for exchange rate conversion and costs!
Enclosed: I enclose cheque / money order for Booking Deposit (if making application more than 30 days prior to the rental period). Total Amount Owed (if making application within 30 days of the start of rental period). For foreign currency transactions, any unpaid amounts owed or refunds paid will reflect the current rate of exchange and currency exchange charges at the time of payment.
Cancellation fee per rental period (applicable only in last 45 days) $200

(c) G.& S. Corke 2019   To print form to a file press Enter then dbl click here Print form to file

The signee(s) ACKNOWLEDGE AND CONFIRM THAT I (we) HAVE READ AND AGREE TO ALL CONDITIONS ON THIS APPLICATION. I acknowledge and agree that this application upon receiving confirmation of acceptance, shall be a binding contract in force between the signee(s) below and the cottage owner.

The signee(s) agrees(agree) that I(we) will be responsible for any damages caused by the signee(s) below or anyone in my(our) party to property or persons. The signee(s) agrees(agrees) that I(we) will keep the rental cottage and all furniture, chattels, fittings and effects in or about the rental cottage in the same state of repair and condition as at the commencement of the cottage rental and SHALL LEAVE THE COTTAGE IN THE SAME STATE OF CLEANLINESS AND GENERAL ORDER IN WHICH IT WAS FOUND OR THE CURRENT MINIMUM HOUSEKEEPING CHARGE WILL BE DEDUCTED FROM THE BOOKING DEPOSIT. The signee(s) agrees(agree) to remove all garbage (including bottles) to the disposal hut. The signee(s) agree to indemnify and save harmless the cottage owner from any claims during or arising from my(our) use of the Burridge Lake Cottage referred to in this application.

Mail or fax this form after printing a hard copy!


________________________________ AND _____________________________ Signatures

Date ___________________________________

Once completed, use button above to print to file, print the saved file, sign and fax
or attach the printed file in an email to sacorke@sympatico.ca.com
FAX: 613-823-9055. Finally You can mail to us now by checking the form and click the button on the right!

Clicking Email indicates to the owner your intent to rent.