Form

Online booking for Celebrate Wales: 21st and 22nd April, 2018
Completion Date

/ Day / Month Year
The first named person will be our contact point for the whole booking
Full Name *

First Name/Given Name Last Name/Family Name

Address

Street Address Line 1
Street Address Line 2
City/Town	County
Post Code	Country

Mobile phone

- Prefix Phone Number
Home phone

- Area Code Phone Number
Your parish or church
E-mail *
E-mail address you wish us to use in correspondence with you
We would like to send you information about Celebrate events this year and next. To comply with Data Protection rules we need to ask you to confirm that you are happy to receive emails from CELEBRATE about our conferences, CELEBRATE@home, and any other CELEBRATE-led activities. Please indicate your preference by ticking "Yes" or "No" below

Yes, e-mail me to keep me up to date with all CELEBRATE Events. I understand I can unsubscribe any time from receiving these e-mails by contacting info@celebrateconference.org No, I do not wish to receive e-mails about CELEBRATE Events
PLEASE COMPLETE THE FOLLOWING REGISTRATION INFORMATION FOR ALL ATTENDEES

IF YOU WOULD LIKE TO MAKE AN EXTRA DONATION TO HELP OTHERS TO ATTEND, PLEASE ENTER THE AMOUNT IN THE DONATION BOX AT THE BOTTOM OF THE PAGE

WHEN YOU HAVE COMPLETED THE FORM, CHECK THE TOTAL TO PAY BOX AT THE BOTTOM OF THE PAGE, THEN SUBMIT THE FORM

WE WILL SEND YOU A CONFIRMATION E-MAIL WITH PAYMENT INSTRUCTIONS

THANK YOU
BOOKER *

First Name Last Name
School Year
Date of birth: under 21

/ Day / Month Year
Booking fees information
Payment due 1 *
ATTENDEE 2

First Name Last Name
School Year
Date of birth: under 21

/ Day / Month Year
Booking fees information
Payment due 2
ATTENDEE 3

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 3
ATTENDEE 4

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 4
ATTENDEE 5

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 5
ATTENDEE 6

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 6
ATTENDEE 7

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 7
ATTENDEE 8

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 8
ATTENDEE 9

First Name Last Name
School Year
Date of birth: under 21

- Day - Month Year
Booking fees information
Payment due 9
DONATION
TOTAL TO PAY
Should be Empty:

Online booking for Celebrate Wales: 21st and 22nd April, 2018