Date required                From………………………To ……..……………..

Alternative date            From………………... ……To…….….……………

Name …………………………           Tel: code…………..No……………

Address ……………………………………………………………………

……………………………………………………………………………..

…………………………………… Postcode……………………………...

Please list names of party including applicant

Mr/Mrs/Ms.      Age if under 18.

1…………………………………       7……………………………………

2…………………………………       8……………………………………

3…………………………………       9……………………………………

4…………………………………       10…………………………………..

5…………………………………       11…………………………………..

6…………………………………       12…………………………………..

I enclose a cheque / P.O. in the sum of £……………… for a deposit.

Cheques made payable to :- M.P.Raines.

I have read and agreed to abide by the terms and conditions of booking.

Signed………………………………………………   Date………………...

Name (printed)……………………………………………………………..

Bookings to be made to :-                

Mrs. M.P.Raines
The Hermitage
Burythorpe
Malton
North Yorkshire
YO17 9LF

Tel:-   (01653) 658201