Guest Booking Form :: MK Christmas Day Party for the Elderly

Title:

Mrs

Mr

Miss

Other

Guest's Name:

Age:

Gender:

Male

Female

Address:

Postcode:

Contact number:

Email

Attended party before?

Yes

No

PHYSICAL ASSISTANCE: Check all that apply:

Uses a wheelchair

Uses a walking frame

Uses a walking stick

Able to sit in the front of a car only

Medical issues that we need to know about e.g. requires medication during the event? Please give details.

Requires having special food? Please give details.

Are there any known allergic reactions to any particular foods? Please give details.

Date

I agree to MKCDPE holding my personal details for the purpose of this event.

GUEST BOOKING FORM