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Halloween Party

Do You Dare To Be Scared? Come to The Zone on 6.00 pm - 8.00pm 7.50 Per Child 5 yrs - 12 yrs

Wednesday 31st October 2012

Book now at reception to avoid disappointment ! Closing date for booking is Monday 29th October. For more information or to book please contact: 01484 484134 / reception@thezone.uk.com

APPLICATION FORM
Childs Name 1: ................................. Childs Name.. Age: ... Address:. Postcode: ... Medical Issues: ... Parent / Guardian Details Name: . Contact Numbers: DAY .. NIGHT ... Email Address: ..

Payment Details: Credit / Debit Card - Solo


Card Number Expiry Date

Maestro

Visa

Mastercard

(Please tick box)

Security Number (on reverse of card)

Valid From (Maestro / Solo only)

Issue Number Date


TOTAL AMOUNT

Card Holders Signature .


I enclose a cheque / postal order made payable to Sporting Pride Community Trust

Please print address and course reference on the back of your cheque

(Registered Charity No: 1117768) In the event of my son / daughter being injured whilst attending an Zone Activities session and I cannot be contacted on the above number, I hereby give my consent for my son / daughter to receive medical attention. YES / NO I agree that The Zone venue are NOT liable for any loss, damage or injury which may arise as a result of my son / daughter attending. YES / NO Do you have any objections to photographs being taken of The Zone Activities for publicity purposes. YES / NO * Please note - once you have returned your application form you will NOT receive confirmation. Please arrive at the venue unless informed otherwise

Mail to: The Zone, Off St Andrews Road, Huddersfield, HD1 6PT If you would like to book or require further information please contact: Main Reception: 01484 484134 :

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