Gift Certificate Order Form
If you do not receive a confirmation email within 24 hours, please call or email us.
Name(s) of person buying certificate:
Email: (must fill in or it does not show)
Mailing Street Address: (address of CC billing) Address:
City,

State Zip

Who is this Gift for: Name on Certificate:
If you want us to mail it directly to them, please enter their address, or leave blank if not
Your phone Number:
How did you hear about us?
(what search engine or link did you use)
Which room would you like to book? Laurel Suite ($195 Friday or Saturday weekend stay plus tax)
Laurel Suite ($175.50 Sunday - Thursday weekday stay only)

Parlor Room ($180 Friday or Saturday weekend stay plus tax)
Parlor Room ($162 Sunday - Thursday weekday stay)

Mountain View ($155 Friday or Saturday weekend stay plus tax)
Mountain View ($139.50 Sunday - Thursday weekday stay)

Vineyard Room ($150 Friday or Saturday weekend stay plus tax)
Vineyard Room ($135 Sunday - Thursday weekday stay)

Garden Room ($145 weekend stay , Friday or Sat. plus tax)
Garden Room ($130.50 weekday, Sunday-Thursday)
Check In Date if known otherwise leave blank: Gift Certificate is good for one year. The bearer can call and book their night within one year of receipt.
Number of nights: Number of Guests (1 or 2): Rates based on double
occupancy - no more than one couple per room please. No children
Spa Packages (Massage only):

Massage Package ($75.00 one person)

Massage Package ($150.00 two people - massages are one at a time)

Couples Massage ($175.00)

Preferred day and time of treatments:

 Spa Packages (w/ skin care treaments):

Couples Relaxation Package ($280.00 for two people - includes 2 massages and two facials)

One Facial Treatment $75

Two Facial Treatments $130.00

One Facial plus one Massage $140

Preferred day and time of treatments:
Add On Romance Package ($95.00 Addl)
List if you prefer Champagne, Red or White Wine or Sparking Cider.

Spa Therapy Basket ($45.00 addl)

Wine Therapy Spa Basket ($65.00 addl)
Credit Card Information:

Card to be billed
CC#:
Sec. code listed on back		 Type: (MC, VS A/X, Discover: Exp Date:
Please list any dietary restrictions, food allergies or dislikes, comments (i.e.: vegetarian, diabetic, no cantaloupe, grits, cheese, ...) Please enter any comments below: Check-in is between 3pm - 8pm. Please let us know if you require a late check-in. If you want to do a dollar value rather than a room, list it here.
If you were unable to send this form, or do not receive a email confirmation within 24 hours, contact us via regular e-mail at info@mountainlaurelcreek.com
Color