Booking Form
 

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BOOKING FORM
 

Please print this form out, complete in BLOCK CAPITALS
and return with the fee to:

GS Squash (Adult Courses),
Panel Cottage, Church Street, Amberley, West Sussex, BN18 9ND, England

Cheques should be made payable to 'Graham Stevenson'.  Alternatively, please contact Graham re. account details for electronic payment / e-mailed booking form.

Name of Applicant : ......................................................

Date of Birth : ..............................

Address : .............................................................................................
             ................................................................................................
            ................................................................................................


Telephone (home) : ........................................ (work) : .............................

Email Address: ..........................................................................................

Course applied for
(enter dates) : ...............................................................

Indication of playing standard :  ...............................................................


Details of any special dietary requirements, allergies, medical conditions, etc.

....................................................................................................................

....................................................................................................................

Name of your Club/Centre: ............................................................................

E-mail Address of Club/Centre:.......................................................................

....................................................................................................................

DECLARATION
: I accept the booking conditions as detailed.

Signed: .............................................................  Date: .............................

 

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