| |
| Name
of party: |
________________________________________________________________________ |
|
| Occasion: |
____________________________________________________________________________ |
|
| Date
& Time of Party: |
___________________ |
No.
of party people: |
_____________________ |
|
| Deposit
(£10.00 per person): |
_______________________________________________________ |
|
Payment
method: |
Cheque
/ Credit Card / Debit Card / (Please circle) |
|
| Cheque
number: |
_____________________
(Please write your 'party name' on the back of your cheque) |
|
|
Name of Card i.e. Visa / Mastercard: |
_____________________________________________________ |
|
| Card
number (long one through the middle of the card): |
______________________________________ |
|
| Expiry
Date: ___________/___________ |
Issue
number (if applicable): ___________________ |
|
| Name
on Card: |
_______________________________________________________________________ |
|
| Are there any
special requests or dietry requiremnets? |
| ___________________________________________________________________________________ |
___________________________________________________________________________________ |
___________________________________________________________________________________ |
|
| Name
of Organiser: |
___________________________________________________________________ |
|
| Address: |
_____________________________________________________________________________ |
| Address: |
_____________________________________________________________________________ |
|
| Postcode: |
____________________________________________________________________________ |
|
| Home
telephone no: |
___________________________________________________________________ |
|
| Work
telephone no: |
___________________________________________________________________ |
|
Please print
and return this form to the following address
Tequila Max
109 Whiteladies Road
Clifton
Bristol
BS8 2PB |
|