Guest Booking Form :: Christmas Party for the Elderly

Your Name

Title

Mrs

Mr

Miss

Other

Age

Gender

Male

Female

Address

Postcode

Phone numbers

Email

Guest Information - Physical Assistance

Uses a wheelchair

Uses a frame

Uses a stick

Can sit in the back of a car

Medical and dietary requirements

Requires taking medication during the event

Requires having special foods

Any allergic reactions to foods

If any of the above please specify

I agree to MKCPE to holding my personal details for the purpose of this event. Your details will not be shared outside of the committee.