Avalon Marshes Centre 15 – 17 July
2016
BOOKING FORM
NAME OF YOUNG PERSON: ……………………………………………………………………………………
DATE OF BIRTH:…………………………………………………………………………...
ADDRESS:……………………………………………………………………………………………………………………………………………………………
EMAIL ADDRESS:…………………………………………………………......
CONTACT TELEPHONE NUMBERS:……………………………………………………………………...
NAME OF PARENT/CARER:…..…………………………………………………………
EMERGENCY CONTACT:…………………………………………………………………….
RELATIONSHIP TO YOUNG PERSON:……………………………………………………………………......
ADDRESS:……………………………………………………………………………………………………………………………………………………………
TELEPHONE NUMBER:………………………………………………………………………..
EMAIL ADDRESS:………………………………………………………………………
I WILL BE ATTENDING THE EVENT [ ]
I WILL NOT BE ATTENDING THE EVENT [ ]
I CONFIRM THAT PHOTOGRAPHS OF THE YOUNG PERSON MAY BE USED
IN PUBLICITY MATERIAL
SIGNED:…………………………………………………………….. PRINT
NAME: …………………………………………..
Please bring you COMPLETED
FORM with you together with £20 to cover food and refreshments (unless a grant
has been given)
Included in the
price of a ticket are all meals and refreshments but you will need to pay for
your camping costs (unless a grant has been awarded). The cost of camping is significantly reduced
buy sharing a large tent and therefore please advise whether you wish to share
a large tent, whether you have one or whether you will be bringing a small tent.
Please let us know about any dietary requirements, allergies, medical complaints,
food you do or do not like or problems that could arise (for all delegates)
…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
SIGNED:…………………………………………………………………………
DATE ……………………………………………………………………………
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