Return to Well Road Centre, Moffat
Name of Group : ____________________________________________
Lead Name : ________________________________
Postal Address :
Street : _____________________________________________________
Town : _________________________________________________
City or County : _________________________________________
Post or Zip Code : __________________ Country : ____________________
Telephone Number :__________________ Fax Number : ___________________
Date of Arrival :_________________________________________
Date of Departure :_______________________________________
Estimated Group Size :____________________________________
Deposit Enclosed (Pounds Sterling) :________________________
N.B. : Cheques on Scottish or UK banks only, backed by banker's card. Never send notes or money by post. Contact us to discuss other forms of payment.