Please do not reduce page size below A4 or print double sided because it does not suit our system.
Please print clearly.
The first name given will be deemed to be the person responsible for this booking and to whom all correspondence will be sent.
Surname / First name (as you
want it to appear
on your badge) / Email address / Date of birth
(if under 18) / CTC/ECF Member
No /Expiry date
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2
3
4
5
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NB –Please include all email addresses as event information, route sheets and .GPX files will automatically be emailedto everyone who has included their address - see Additional Information under maps, route sheets and .GPX files.

A parent or guardian must accompany anyone under 18 years of age.

Address:
Post Code: / Phone(day) / (evening)
(mobile)

Residential Accommodation

NB – All rooms,(single,double or twin-bedded),are on a Dinner, Bed and Breakfast basis (Half Board)and include all other available amenities.

To qualify for the reduced child price, a child must not have reached his or her 18th birthday as at 13 August 2018.

Camping

To qualify for the reduced child price, a child must not have reached his or her 18th birthday as at 13 August 2018.

If booking as part of a local CTC group, please give its name: …………………………………………….……….……

Packages

NB–The amount shown in red is the price payable if booked after 20 April 2018.

Packages / Price / Price / No of people / Total
Amount
Package 1 – Single room per person, half board / £400 / £450
Package 2 – Double room per person, half board
2 people must book together / £355 / £405
Package 3 – Twin room per person, half board
2 people must book together
Adult / £375 / £425
Under 18 at 13/08/18 when sharing with parent/guardian / £260 / £310
Package 4 – Camping per person, half board
Pitch required (give numbers) / Small Tent / Large Tent / Motor
home / Camper
van / Caravan
Adult / £300 / £350
Under 18 at 13/08/18 when sharing with parent/guardian / £180 / £230
Package 5 – Camping per person, self-catering
Pitch required (give numbers) / Small Tent / Large Tent / Motor
home / Camper
van / Caravan
Adult / £200 / £250
Under 18 at 13/08/18 when sharing with parent/guardian / Free / Free
Registration only -forpeople arranging their own accommodation.
Price per Person / £100 / £100
Optional Events –Coach trips will be subject to sufficient numbers.
National Brewery Centre and National Memorial Arboretum / £22 / £22
Anderton Boat Lift / £22 / £22
GRAND TOTAL FOR ALL ITEMS / £

Additional Information

For each person listed on this booking form please give the following information(use a separate sheet if necessary).

Any medical, mental or physical condition or learning difficulty that the event organisers or emergency personnel should be aware of (including any medications that you take):

The name, relationship to the participant, address and telephone number(s) of the person you would wish to be contacted in case of an emergency:

Special requests: meals (e.g. vegetarian/gluten-free/wheat-free/diabetic),other: (special requests cannot be guaranteed and are subject to availability)

Please circle your main mode of transport to Yarnfield -cycle / train / motor vehicle / vehicle share

Have you been to the Birthday Rides before? YES / NO. If YES, circle the number of times 1 2 3 4 5+

Declaration

I have read and understood the Prospectus and the Booking Conditions. I am authorised to accept the conditions of the booking as specified on behalf of all persons named on this form and request CTC Cycling Holidays & Tours Ltd to book the arrangements set out above. I confirm that the above information is correct and complete.

Payment

I enclose a cheque (payable to CTC Tours) or the credit/debit card authorisationform on Page 4 for the full payment.

NB - to avoid the need to send another cheque, it is important that only this payee name is used.

Signature / Please PRINT name / Date

Please return to: - BR Bookings, 1 Ryelands, Radbrook, Shrewsbury SY3 9BZ

Complete this form if you wish to use your credit or debit card to pay for this booking. Please bear in mind the expiry date of your card. PLEASE PRINT CLEARLY.

I hereby authorise my credit / debit card (circle which) to be charged as follows:

Visa / Mastercard / Maestro (circle which)Number: ______

Starts: ______/______Expires: _____/______3-digit code: ______

Total amount £______

Name (print) / Booking ref: / 18BR-
Signature / (for office use only)

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