Zoence Special Event: Booking Form (per person)

To book a place on the event, please fill out the form below, print it out, sign it and then post it with the full or ‘early bird’ fee, as appropriate, to Zoence Academy at the following address:

The Secretary, Zoence Academy,
Roses Farmhouse, Epwell Road, Upper Tysoe,
Warwick, CV35 0TN, England.

If for any reason you cancel your booking, all payment for the event less £25 will be returned if the cancellation is made at least three weeks before the event. If notice of cancellation is less than this, the whole fee may be forfeit.

Please let us know of any special needs on this form.

Please select/tick/fill in the boxes as appropriate.

I wish to book a place on:

‘Gateway to the Heart of the Grail Land’ (8-9 May 2010: £125*/£150)

‘The Swan Knight & the Holy Grail’ (3-4 July 2010: £150*/£175)

‘The Grail Land & the New Age’ (25-26 Sept 2010: £150*/£175)

* ‘Early bird’ fee.

Personal Information-1
(Except for the purpose of organising the event, this information will be kept confidential.)

I will require (select/tick as appropriate for the event):

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:

Personal Information-2
     
Title
 First name
 Last name
       
House/Street address
City/Town/Village
County/State/Province
 Postal/Zip Code
Country
     
Phone (incl. code):
 Fax:
 E-mail:

Please tick if you do not wish to have the above information (PI-2) shared with other associated organisations:

I understand that some special events may carry certain risks (e.g. uneven ground for walking, 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 enclose a for £ made payable to Zoence Academy
(all payments to be made in £ Sterling).


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