Baslow Boot Bash
Saturday 15 June 2019
Application Form
Our contact details - for cheques, S.A.E. or enquiries:
Heather Jacques, Fern Cottage, Main Road, Grindleford, Hope Valley S32 2JN, tel 01433 631586
Which event do you wish to enter? *
What is your first name? *
Your answer
What is your surname? *
Your answer
What is your address? *
Your answer
And your post code ? *
Your answer
Landline number (if any)
Your answer
What is your mobile number (to contact you during the event)?
Your answer
What is your email address? (If no email address, please send S.A.E. to Heather at the address at the top of this form)
Your answer
Are you
If you are participating with a club or group, please give its name below.
Your answer
What is your age (if under 18)?
Your answer
The standard meal includes meat pie and peas. If you prefer an alternative, please indicate below
Payment
BACS: RBS, Baslow Boot Bash, Sort Code 16-15-17, Account number 10080222. Use your surname as your reference.

Or cheque, payable to Baslow Boot Bash, by post to: Heather Jacques, Fern Cottage, Main Road, Grindleford, Hope Valley S32 2JN

The entry fee is £15. How do you propose to pay? *
Declaration
I acknowledge and accept that the Baslow Boot Bash will store and hold some personal data about me in its computer systems and paper records, in accordance with its policy under the General Data Protection Regulations, as published on the Baslow Choir website.

By submitting this form I agree that I have read and agree to abide by the conditions of entry, which are published on the website, www.baslowchoir.co.uk/bootbash

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