If your reservation has been confirmed you may copy and print the Rental Agreement below.
Send with your downpayment to: Jeanne Jacak, Heaven on Shawano, N989 Boltonville Road,
Random Lake, Wisconsin 53075
Rental Agreement     [] Heaven Cabin            [] Paradise Cabin

Name____________________________________________________________________

Street Address______________________City______________State_______ Zip_________

Home Phone___________________________________Cell Phone____________________

Email Address______________________________________________________________

Date of Arrival________________________________Date of Departure________________                        

Names of Guests (4 guests at $900/wk include ages of children over 2 yrs old, if applicable):

1._______________ 2._______________ 3._________________4._______________

Name(s) of Children under 2 at no charge (if applicable): ____________   ____________

Additional Guests at $50/wk:________________  _______________  _________________  

_________________   _________________  _________________   ____________________
Overnight guests are allowed.  The rate is $10 per overnight guest per night payable at check-out.

                           Total Adults_________  Total Children_________  

Will you be bringing a pet?   []Yes   []No  If yes, list breed and dog’s name:________________
 (One pet allowed.  $50/week)                                                                              

 Do you want to reserve the pontoon at $250/wk? [] Yes  [] No [] We will decide when we get there.

I have read the Rental Information on the website and agree to rental terms and conditions. 

Guests's Signature_________________________________  Date_______________________

 Please return this form to us with your down payment of $200.

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