Home  Booking form to Print out

Please complete and send to: Boghill Centre, Boghill, Kilfenora, Co.Clare, Ireland

First Name………………………………………………….Surname…………………………………

Male /  Female   Date of Birth………………………………………….

Address…………………………………………………………………………

………………………………………………………………………………………..

Telephone…………………………Mob Phone……………………E-mail………….............

In case of emergency list contact person and telephone number………………………………

.........................................................................................................................................................

Have you any medical condition we should know about?..................................................

Dietary requirements…………………………………………..

What kind of accommodation would you like?   Hostel *  -  Private Room *  -   Double Room *    

For a Double room please identify the person sharing..................................................................

What kind of workshop do you want to follow?..........................................

If a music workshop what instrument do you play?............................................
How long have you been playing?............

Date workshop…………………… Do you want to stay additional nights? Y / N
(€21hostel , €32 private room)

Please specify which night(s)............................................................................................

Do you need a pick up from airport / station ?  Y / N  (contact us to arrange- extra charge applies)

Where did you hear about the Boghill Centre?.................................................

Discount past participants 5%  Y/N   Discount second workshop 5% Y/N  Discount advance payment 5% Y/N

I have enclosed ................Deposit / Full Price
I have paid by bank draft.................
Bank Details: Ulster Bank, Ennis Branch, Sort Code:985680 Acc No: 52240040
Swift code is:ULSB IE2D  Iban no is: IE 10 ULSB 98 56 80 52240040
The Boghill Centre
A non-refundable deposit of € 50 is required to secure a place. Full payment is required
four weeks before departure.
Cheques in other currencies are accepted. Use current exchange rate, balance paid on arrival

Signature…………………………………………………………………

Date…………………………………….