DIAL A BREAK BOOKING FORM
Please print and complete as applicable, remembering to indicate which Break you would like to book. Please include £30pp non-refundable deposit to secure reservation, remaining balance due approximately one month prior to commencement of Break, if booking is made after that time full balance will be required...please refer to specific Break for further details. Cheque's to be made payable to P M Faiers and sent to: Dial A Break, The Rise, Norwich Road, Roughton, Norfolk, NR11 8NA
Particular Break & Date Name Address Email Tel. No I would like to reserve.................places for the above stated weekend I would like to reserve ................double room / twin room / single room Please indicate any special dietary requirements Please indicate any other special requests Signed Date