Activities Booking Enquiry Form

Moonlight Marathon Walk 17th & 18th May

Location Robert Sutton School, Bluestone Ln, Burton-on-Trent DE15 9SD
Activities Booking Enquiry Form

Once we receive the filed form we will contact you shortly to confirm your teams place on the walk. The payment of £100 per team of up to 15 walkers is due at the latest Friday 10th May. Cancellations are non refundable. Please Check times, ages and distance needed before completing this form.
Full Name*

First NameLast Name
E-mail*
Phone Number*

Phone Number
Address*

Street Address

Street Address Line 2

TownCounty

Postal /CodeCountry
Team Name
Number of Adults min 1 per group up to 10yrs*
Number of Children Aged 6-7*
5 Miles
Number of Children Aged 8-10*
8 Miles
Number of Children Aged 11-13*
13 miles
Number of Children Aged 14-16*
15 Miles
The Payment of £100 per entered team is required by Friday 10th May

Please calculate the total cost

Payment can be made by cheque or Baccs payment - Please indicate your method of payment.
Total Cost of teams
Method of Payment

ChequeBaccs PaymentBank Transfer
Signature

Clear
Should be Empty:

Moonlight Marathon Walk 17th & 18th May