Room for handicapped persons

We have a room, which is designed for wheelchair users or handicapped persons in the 1st floor(For 2 Peoples).
Wheelchair users and their accompanying peoples can make the reservation by using this form.
*Please read information pages carefully before you send us a question mail.
*Do not use the enter key to fill out the form, it might send your email before you confirmed it.
*We will reply on your email within 3 days. If you do not receive our reply, it means we have not received your email, so please send it again.(Please read this too!)
Booking details
Check-in Date *We only accept your reservation from 90 days before your arrival.
*If you want to book less than 3 days before your arrival date, please contact us by phone.
(month)(days)
How many nights? 　or, in case of more than 7nights→ nights
How many people? Adult males Adult females
How many Children? 4-15 year-old boys , girls
0-3 year-old boys , girls
If you are three persons or more, we’ll prepare two rooms for you.
Room's Type：		 ※Please select your preferred option. ROOM INFORMATION
1st choice
2nd choice
Breakfast
Japanese style
630 JPN		 With Breakfast
Without Breakfast
If there are any days on which you do not want breakfast.
　
Not decided yet (If you need it, please let us know at least two days before.)
Personal details
Full Name
E-mail
*We will send a confirmation e-mail to the entered mail address.
male or female male female
Age
Nationality Other?
YH member's number
(if a member)
Do you smoke? *You can not smoke in any of our rooms. Please smoke at smoking area.
Do you use wheelchair? Yes　No
Do you come here by car? Yes　If so, what time do you come by car?
No
Address Other?
Telephone Number
Purpose of your visiting
Have you ever stayed YH?
Where have you got an information about our YH?		 more than 2 times　 once　 this is the first time

※Please tell me if you select others or name of another site, magagine and retrieved words.
Any additional information
or, requirement
*We respect your privacy and maintain your profile information on a secure server.
* About cancellation, please read this Our Cancellation Policy and please let us know immidiately by email or telephone.
* Please feel free to contact us anytime