Gift Certificate Form

Please fill out the form below to request a gift certificate.
After you click on the Submit Button below you will see the payment page.
Use <tab> to move to next field - <Enter> will submit form

Purchaser's Information: ** required

**First name
**Last name
**Street address
Address (cont.)
**Zip/Postal code
**Phone 1
Phone 2
**Email Correct?
**Certificate Amount US Dollars

Special message or occasion to include on Certificate:

Please include other information or questions to help us process your request:

Email certificate to purchaser 
Email certificate to recipient    If to recipient please enter Email below.

Recipient's Information: ** required

**First name
**Last name
Email Correct?
Street address
Address (cont.)
Zip/Postal code
Phone 1
Phone 2

To prevent spammers from
using this form please enter
the number into the field below

Enter number here:

This gift certificate is only refundable to purchaser. If no booking has been made full refund less a $30 administration fee and any credit card fees. Once booking is made the refund amount is subject to the cancellation clause of the Rental Agreement.

By providing your phone number, you give us permission to call you in response to this request, even if this phone number is in the State and/or National Do Not Call Registry.

Ready to send the form?

Please report any problems with this or the payment form to

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Nantahala river vacation homes for rent near white water rafting.