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BRACKNELL TRAMPOLINE CENTRE

PRIORITY BOOKING FORM

EASTER TERM 2011 **Form to be returned by 26th March to keep your place**

NAME…………………………………………………….DOB (if child) …………...

CURRENT COURSE………………………………………………………………... OR PLEASE RE ENROL ME ON NEW COURSE (if changing)

DAY……………………………………. TIME……………………………………… List your choices on reverse indicating if you can remain on current course if necessary

TELEPHONE…………………………...MOBILE………………………………….

E MAIL ADDRESS…………………………………………………………………...

E mail address is required for course confirmations and re enrolment.

EMERGENCY CONTACT NUMBER……………………………………………...

Please provide an emergency contact number for all adult courses and courses where parents will be leaving the centre for their Childs training. ANY MEDICAL CONDITIONS……………………………………………………..

PAYMENTS Please indicate your chosen payment method. No refunds or credits given for cancellation. Please help us to save bank charges by paying direct into our bank account.

• I have paid direct into BTC bank account. Date paid…………………

30-91-11 a/c 03693943 amount paid £………………………………. Please quote name of person on course as reference

• Please take from my visa/master card no…………………………………………………..Expiry date……………

Security code……………… amount £…………………….

• I enclose a cheque payable to Bracknell Trampoline Centre (we get charged for cheques)

• Payments can now also be made via telephone.

I confirm that I have seen and will comply with the BTC information and rules and BTC’s terms and conditions which are published in full on the website.

SIGNATURE…………………………………………DATE……………………….

Please return your completed booking form together with payment to Bracknell Trampoline Centre, 21 Augustine Walk, Warfield, Bracknell, Berkshire, RG42 3DX, or return in an envelope to the post box marked BTC inside

trampoline hall in the centre.

***By 26th march please***