Dance Weekend Booking Form

	Order Form

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Leroc Modern Jive
The Redcliffe Hotel, Paignton 17th ~ 19th October 2008
£130 per person

Complete the details below and then click the "Submit Order" button, then choose your payment method.
For multiple bookings please use the name and address of the person we should contact for the lead name and details. All other names should be entered into the "Additional Names" spaces provided on the right.
Please note that items marked * are required fields but we would be grateful if you could complete as much as possible.

After completeing this form, deposits required are £40 per person and payments can be made securely online with PayPal by clicking the "Pay Online" button below, or by cheque to the address shown at the bottom of this page.

Lead Name: *	Additional Names 01 02 03 04 05 06 07	Additional Information
Address: *
Post Code : *
Telephone:
Email:
What happens next After you have completed the form and pressed the 'Submit Order' button we will contact you within 1 or 2 days to confirm your booking. Please note that all bookings are provisional until we receive a deposit(s) from you.