平野邸 Hayama

Reservation form

Please fill in your booking details.

facilities

Space Hire

Date

Type & Price required

Number of people required

（If you have a member ID）
You can omit entering applicant information by your member ID.

Member ID（6digits）

E-mail

（If you don't have a member ID）
Please select from the following options if you would like to receive a member ID.

Issue a member ID required

Yes
No

Please fill in the applicant information.

Name required

Gender required

Male
Female

Age required

Address required

Phone number（without hyphen） required

E-mail required

Usage required

Message

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