Send completed form via fax to +44 (0) 1273 325081

Title:
First Name:
Surname:
Date Of Birth:
Day Month Year
Flat No:
House Name:
 
House Number:
 
Street:
District:
City:
County:
Post Code/Zip:
Function Details (e.g. Wedding):
Nearest Hotel:
Nearest Airport:

Appearance Fee: 1,500 / $2,250 (1/2 of which will be donated to Charity)

Confirmation

I hereby confirm the above booking and upon receiving your acceptance, I will pay 300 / $450 non-returnable deposit by Bank Transfer. I will pay the balance of 1200 / $1800 at least 28 days before the Function Date. I will book and pay for a hotel room near the function address for the night preceding the function. I accept that no refund will be made in the event of my cancellation.

............................................. Signature

Bank Details

Name:
Address
Account Number
 

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Name of Account Holder