FBRT Golden Heart of Europe Pilgrimage 2010
Booking Form (per person per event)

To book a place on the pilgrimage, please fill out the form below, print it out, sign it and then post it with either the full fee or £200 (or €200) deposit to the FBRT at the following address:

The Secretary, The Francis Bacon Research Trust,
Roses Farmhouse, Epwell Road, Upper Tysoe,
Warwick, CV35 0TN, England.

If booking is made with the deposit only, the rest of the fee is payable by 6 May 2010. Any bookings made after this date must be made with payment of the full fee.

If it should be necessary to cancel a booking before 6 May 2010, all monies paid less the deposit of £200/€200 will be returned. Any cancellations made after this date will forfeit all monies paid, unless the place can be filled by someone else.

If you are worried about the possibility of any unexpected need to cancel your booking, we suggest you take out suitable insurance to cover for such a contingency. In any case, every participant on the pilgrimage is required to have suitable travel insurance and to be responsible for their own known health and welfare issues.

Please tick/fill in the boxes as appropriate, and let us know of any special needs on this form:

I wish to book a place on the Golden-Heart of Europe Pilgrimage 30/05/10-06/06/10

Full Fee:
£1125 / €1215 per person (shared twin/double room)
£1230 / €1330 per person (single room, if available)

Personal Information-1

Title
 First name
 Last name
       
House/Street address
City/Town/Village
County/State/Province
 Postal/Zip Code
Country
     
Phone (incl. code):
 Fax:
 E-mail:

Personal Information-2
(Except for the purpose of organising the event, this information will be kept confidential.)

I will require:

Normal diet Vegetarian diet Special diet* (i.e. because of allergies, intolerances)

*Please give details

single accommodation shared twin accommodation*
shared double accommodation*

* I wish to share with

I have: good health health problems*

*Please give details (e.g. physical/mental ailments/handicaps):

Additional details that might be helpful to the organisers:

Personal Information-2 will not be shared, but please tick the box if you do not wish to have Personal Information-1 shared with other associated organisations.

I understand that all pilgrimages carry certain risks (e.g. uneven and sometimes rocky ground, uncertain weather) and am fully prepared to be responsible for my own safety and health, physical and psychological, as far as is normal and reasonable in such circumstances, and to have suitable and sufficient personal clothing and footwear.

I have or will have sufficient health and travel insurance for the pilgrimage.

I enclose a for £ made payable to the FBRT
(all payments to be made in £ Sterling).

Or, if you wish to pay in Euros, please contact FBRT Secretary for details of Euro bank account into which payments should be made.


Signature: ........................................................................ Date: .......................................