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This form may be used to book your Birdwatching Breaks Holiday. If you wish to include your deposit, either by cheque or credit card, then please use the Printable Version of this Form.
Title (name exactly as it appears on passport)

 

Surname:

First or preferred name:

Date of Birth:
(dd/mm/yy)

Address:

 

Number or house name:

 

Street:

 

Village or Town:

Postcode:

 

Country:

 

Home Tel/Fax No.:

e-mail address:
@

 

Please reserve me place(s) on your holiday.

I will be making my own flight arrangements YES NO

If possible I would like to fly from:

Manchester

 

Glasgow

 

Birmingham

Edinburgh

Accommodation required: Single Twin Double

I would be prepared to share in twin-bedded accommodation: YES NO

What type of passport do you hold?

Passport Number(s):

Expiry Date(s): (dd/mm/yy) (dd/mm/yy)
Please note that your Passport(s) must have at least 6 months to run after the return date of your holiday.

I/we hold an annual/single trip insurance policy with:

(Please forward a copy of your insurance poilcy to us)

Do you have any special dietary requirements?

Is there any food that you dislike?
(This will help when contacting Hotels)

Have you any food and/or other allergies? YES NO
(If YES please give brief details below)

 

Have you any pre-existing medical conditions? YES NO
(If YES please give brief details below)

 

Where did you hear about Birdwatching Breaks?

 
I have read and fully understand the Terms & Conditions

Please ensure that you have entered your details correctly before activating the submission button.

 

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