| BLOCK CAPITALS PLEASE |
1. FULL NAME................................................................................................................................................. |
| Address......................................................................................................................
............................ |
| ........................................................................................................................................
.............................. |
| Home telephone................................
. Day
telephone....................................
... |
E-mail............................................................... |
2. FULL NAME................................................................................................................................................. |
| Address......................................................................................................................
............................ |
| ..............................................................................................................................Post
Code............................. |
| Home telephone................................
. |
Day telephone....................................
... |
3. FULL NAME................................................................................................................................................. |
| Address......................................................................................................................
............................ |
| ........................................................................................................................................
.............................. |
| Home telephone................................
. |
Day telephone....................................
... |
4. FULL NAME................................................................................................................................................. |
| Address......................................................................................................................
............................ |
| ........................................................................................................................................
.............................. |
| Home telephone................................
. |
Day telephone....................................
... |
| 5. DATES REQUIRED........................................
6. DIETARY REQUIREMENTS
.........................................................................................................
....................................................................................................................................................................
I have read the Booking Conditions and accept them on behalf of all my party on whose
behalf I am duly authorised to make this agreement. I am over 18 years of age.
I enclose a cheque for the deposit (£150 p.p.) or full payment (within eight
weeks of departure) payable to Orpheus & Bacchus.
Alternatively: Credit Card No.
................................................................... Exp.date.
................... Security No.......
Exact name and title on card ............................................ |
DATE............................SIGNED...................................................................................... |
Please return to: Ian Christians: Reinhardtstrasse 41, Berlin 10117, Germany. Tel/fax: +49 30 2759 4174/5, Mobile: +44 7808 727735. e-mail ian@orpheusandbacchus.com |