Events booking form

Name *

First Name

Last Name

Forthcoming events:

Please tick each of the events you wish to attend:

Sun 6 Apr - Pinocchio (Members £25 / Essential Carers £25 / Non-essential parent/carers £30)

Mon 7 Apr - AirHop (Members £18 / Essential Carers £18 / Non-essential carers £20 / Non-participating carers FREE) OR

Mon 7 Apr - Clip'n Climb (Members £18 / Essential Carers £18 / Non-essential carers £20 / Non-participating carers FREE)

Tue 8 Apr - Geek Retreat (Members £20 / All Carers FREE)

Wed 9 Apr - Hackers (Members £25 / Essential Carers £25 / Non-essential carers £30 / Non-participating carers £5)

Thu 10 - Fri 11 Apr - Darsham Residential (Members £150 / Essential Carers £150 / Non-essential carers £160)

Mon 14 Apr - Pottery Class (Members £20 / Essential Carers £20 / Non-essential carers £25 / Non-participating carers £5)

Tue 15 Apr - London Science Museum (Members £25 / Essential Carers £25 / Non-essential carers £30)

Wed 16 Apr - Romford Greyhound Stadium (Members £25 / Essential Carers £25 / Non-essential carers £30)

Thu 17 Apr - Flatford Mill & Dedham Tour (Members £40 / Essential Carers £40 / Non-essential carers £45)

Sat 3 May - Charity Barn Dance (Members £16 / Essential Carers £16 / Non-essential carers £16)

Wed 18 Jun - Calendar Girls (Members £15 / Essential Carers £15 / 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

Do you require a lift if it can be provided? *

YES, please add the dates to the comment box

NO

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: 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)

Hackers 9 Apr *

Choose one

N/A

Hunters Chicken Wrap – Chicken, bacon, cheese, BBQ sauce with nachos

Halloumi Wrap – Sweet chilli with roasted vegetables and lettuce with nachos (V)

Hot Dog – Cumberland sausage with onions, ketchup, mustard and sweetcorn relish with chips

Cheese & bacon burger with chips (GFO)

Halloumi Burger – Halloumi, beetroot falafel, pomegranate molasses, cucumber mint yogurt & honey with chips (V) (GFO)

Romford Stadium 16 Apr *

Choose one from each course

N/A

Beef burger

Cheeseburger

Veggie burger (V)

Chicken goujons

Jacket potato, CHOOSE Beans/ Cheese/ Coleslaw

The Sun Inn 17 Apr *

Choose a main and a dessert

N/A

Pasta with Braised Winter Greens, Hazelnut, Chilli, Parmesan (V

Pork Schnitzel Bap, Carolina Mustard Sauce, Coleslaw, Pickles, Fries

Rare Breed Beef Burger, TSI Sauce, Cheese, Pickles, Fries

Cheddar Cheese Rarebit, Chilli Jam, Pickled Chilli, Fries

Salted caramel & tosier chocolate tart, malt ice cream

Apple compote, ginger, walnut crumble, raisin, calvados

Crostoli biscotti mille feuille, rhubarb, blood orange, yoghurt sorbet

Barn Dance 3 May *

Choose one

N/A

Fish & Chips

Sausage & Chips

Veggie Burger & Chips (V)

Chicken Nuggets & Chips

Chicken & Chips