BOOKING FORM

Booking Reference:AU12005774

Group: Caring Matters Now

Arrival Date:Friday 21st September2012 (3days/2nights)

Arrival Time:4pm

Departure Date:Sunday 23rdSeptember 2012

Departure Time:4pm

Course:BoreattonPark Multi Activity Short Weekend

Accommodation:BoreattonPark

Accommodation Type:LodgeBoard Basis:Full Board

  1. First Name………………….. Surname…………………………. Age…………
  1. First Name………………….. Surname…………………………. Age…………
  1. First Name………………….. Surname…………………………. Age…………
  1. First Name………………….. Surname…………………………. Age…………
  1. First Name………………….. Surname…………………………. Age…………
  1. First Name………………….. Surname…………………………. Age…………

Item

Basic course cost per paying person (incl insurance)£119.00

1 xfree place per family

Insurance details can be viewed on the PGL website at:

Payments to be made by cheque payable to Caring Matters Now

Cancellation charges:

  • 56-29 days before your course: 60%
  • 28-15 days before your course: 80%
  • 14 days or less before your course: 100%
  • On or after the commencement date – 100% of the total holiday price.
Item / Amount (per paying passenger) / Due Date
Initial Deposit / £24.00 / 24/02/2012
Interim Payment / £36.00 / 23/03/2012
Final Balance / TBC / 27/07/2012

Bedding can be supplied at a small supplementary charge or you can choose to bring your own sleeping bag or bedding. Please complete the relevant box below to notify us of your preference:

Number of sets of bedding required

Bringing own bedding - (please tick the box)

If any participants (or persons on whom participation depends) have been hospitalised and/or had a chronic illness during the last six months, please provide names and details below:

If any members of the party have additional requirements relating, for example, to mobility assistance, behavioural issues, culture, diet etc, please detail below:

Does the participant have any specific medication they will bring with them?

If yes please give details

Does the participant have any allergies?

If yes please give details

You may be required by PGL to complete an ‘Additional Needs Form’. Should this be the case we will send you a copy in due course.

I confirm that I have read the PGL Booking Terms and Conditions enclosed and accept them on behalf of all my party members.

I accept the information detailed in this booking form and that the information I have supplied is correct.

Signature ……………………………………….Date…………………………

Print Name………………………….

Caring Matters Now | CMN, PO Box 732, Cambridge, CB1 0QF | Tel: 07786 458883 | Fax: 0151 281 9717

Charity Reg. 1120988 | |