BOOKING REQUEST FORM
The Rolvenden Rocket Wellbeing Pilot Scheme operated by Rolvenden Parish Council
Group Details
*
Your Group or individual Name
Provided Registration Number
Contact Numbers and Email Address
*
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LANDLINE
MOBILE EMAIL ADDRESS
E-mail
*
Name and Address of Hirer
Street Address
Hirers Name
Address
Addresss 2
Postcode
Your estimated total mileage for your Booking
*
DESTINATION AND PURPOSE
Estimated Number of Passengers (14 Maximum)
*
Please enter the exact number of your party who will be travelling UP TO MAX: 14 persons
Passenger Details
*
ADULTS
CHILDREN UNDER 3 YEARS
CHILDREN 3 - 18 YEARS
WHEELCHAIR PASSENGERS
SENIOR CITIZENS
Other
Outward Journey Date/Time
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Journey Type
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Please enter the purpose of your journey ie: - Social Club Outing
Return Journey Date/Time
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Year
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