OUTER REEF BOOKING FORM 2008                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
name: ........................Date...................


Address:....................................................................................


Telephone no: ............................................... Mobile no:.....................................


E-mail:...................................... 

 	 	
Age:.....................................	 

 	 	
Number in Party:.............................
       	 

 	 	
Date of your Lesson:.....................................	
 

 	 	
Course title:...........................	 
 	 

Please disclose any medical conditions/ disabilities that may be relevant.
These will be treated in strictest confidence.

.........................................................................................................................

Payment Enclosed 25% deposit ...................... Full Payment: ……………………….


Where did you hear about us? ......................................................

Signed:( Parental signature if candidate is under 18 ).                                                                   

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Date: ......................................................................

Please send form to;

Outer Reef, 11 Maiden wells, Pembroke, Pembrokeshire,Wales, SA71 5ET