Events booking form

Name *

First Name

Last Name

Forthcoming events:

Please tick each of the events you wish to attend:

Sat 16 Nov: Seussical the Musical (members £15 / essential carers £15 / non essential carers £20)

Fri 13 Dec: Christmas Party (members £25 / essential carers £25 / non-essential parent/carers £30)

Fri 20 Dec: Christmas at Wimpole Hall (members £45 / essential carers £45 / non-essential parent/carers £50)

Mon 23 Dec: A Christmas Carol (members £25 essential carers £25 / non- essential carers £30))

Tue 31 Dec: Jack & the Beanstalk (members £30 / essential carers £30 / non-essential carers £35)

Wed 22 Jan: Snow White and the Dwarves (members £10 / essential carers £10 / non-essential carers £15)

Will you be attending with or without a carer? *

Please select one from the list below:

Without a carer

With a parent/carer

With an essential carer

Please tick here if you are a wheelchair user:

How will you be paying? *

Please select one from the list below:

Via PayPal (see link below)

Direct Bank Transfer (Please contact us for bank details.)

Cheque/postal order: Made payable to: Grapevine Essex and posted to: Grapevine Essex, c/o Tulip Hall, 31 Clacton Road, St Osyth, Essex CO16 8PA

I would like Penderel's Trust/ECC to be invoiced directly (please provide your reference number below)

FOOD ORDERS

Wimpole Food Order - 20 Dec

Battered Haddock & Chips

Beef Lasagne

Thai Massaman Chicken Curry (mild) (contains nuts)

Oriental Special With Tofu in Black Bean sauce (V)

Mixed selection of ice cream

Chocolate Fondant & vanilla ice cream

Cappuccino Crème Brulee & vanilla ice cream

Pecan tart & vanilla ice cream