BOOKING FORM

 

 

Please wait for details of our next Holiday course before sending in this form. 

 

I/we would like to book for the Qigong Holiday course,

 

 

 

Accommodation

 

 

 

 

 

 

Last name_______________________

 

 

 

First name_____________________

Last name_______________________

 

 

 

First name_____________________

Last name_______________________

 

 

 

Address of contact: House Name/ Number __________________________

 

Street/ Road______________                   Town/City_____________________

 

State/County______________                 

 Zip/Post Code__________________

 

Country__________________

 

Telephone No.____________________  Mobile________________________

 

Fax_____________________________ Email_________________________

 

Website_________________________

 

 

 

Special Dietary Requirements____________________________________

 

 

 

 Would you like to make use of the transfer from and to the airport?  Yes/No (please delete as appropriate) fee

 

 

 

Are you hiring a car to meet you at the airport? Yes/No

 

 

 

Would you like to join the day out excursion ()?  Yes/No

 

 

 

Payment

 

 

 

Please enclose your deposit of        per person

 

 

 

I will pay the balance by  or

 

 

 

I will set up a Standing Order through my bank to pay the balance in six equal payments commencing

 

I enclose my cheque for £             payable to “Three Treasures Health” or

 

I am sending the deposit via bank transfer*   *Please delete as appropriate.

 

 

 

Signature__________________________Date________________________

 

Send completed Booking Form and your Deposit to: Anthony Horrocks,

 

Three Treasures Health, 24 Stoke Road Taunton Somerset, TA1 3EJ Telephone 01823 277733