School/ organisation name: School address: Post code: Contact Name: Mobile: Telephone: Email: Date/s of visit: Course location: Total no. and age range of participants: Payment Please enclose cheque or BACS payment. Deposit of 25% must reach Circle of Life Rediscovery 60 days before date/s of visit or full fee is payable immediately. Cheques payable to Circle of Life Rediscovery CIC. BACS payments Sort Code: 30-95-01 Account No: 03565091. – Please tick here if invoice requested in advance of payment: Yes No Photo Permission Do you give permission for Circle of Life Rediscovery CIC to use video footage and/or photos on our website, leaflets or flyers, and for promotion with funders, external publications, journals, advertising, websites and any other public media. Your full name will not be used. Yes No Signed on behalf of the school: name: Date:
School/ organisation name: School address: Post code: Contact Name: Mobile: Telephone: Email: Date/s of visit: Course location: Total no. and age range of participants: Payment Please enclose cheque or BACS payment. Deposit of 25% must reach Circle of Life Rediscovery 60 days before date/s of visit or full fee is payable immediately. Cheques payable to Circle of Life Rediscovery CIC. BACS payments – Sort Code: 30-95-01 Account No: 03565091. Please tick here if invoice requested in advance of payment: Yes No Photo Permission Do you give permission for Circle of Life Rediscovery CIC to use video footage and/or photos on our website, leaflets or flyers, and for promotion with funders, external publications, journals, advertising, websites and any other public media. Your full name will not be used. Yes No Signed on behalf of the school: name: Date:
School%20-%20org%20Booking%20form%202014%20-%202015.docx