Please complete in BLOCK CAPITALS and return to:        

Mike Girling, 20 Chinthurst Park, Shalford, Guildford GU4 8JH  

NAME……………………………………………………………………………………

NAME OF ORGANISATION…………………………………………………………..

TYPE OF PRODUCT/TRADE………………………………………………………….

CONTACT ADDRESS…………………………………………………………………………………

………………………………………………………………………………………………

TELEPHONE NUMBER…………………………………………………………………..

EMAIL………………………………………………………………………………………

To Guildford Lions Club

1. I/We would like to reserve a pitch
2. I/We have read and agreed to the Booking Conditions
3. I/We hold appropriate Public Liability Insurance in accordance with Condition 17 of the Booking Conditions and evidence of this is enclosed

OR

      I/We do not hold appropriate Public Liability Insurance and, subject to

  Condition 17 of the Booking Conditions, now request cover to be arranged.

      The premium of £5 is included in the enclosed payment.

1. I/We confirm that at the Fayre, no hazardous material will be used or supplied.
2. Cheque enclosed for £25 payable to Guildford Lions Club

Signed………………………………………             Date……………………………….