Name/Organisation ____________________________________________________________
Postal Address _______________________________________________________________
______________________________________________________________________________
Post Code _____________________ Telephone __________________________________
Email address ________________________________________________________________
Booking as: *Team (�600)
*Individual(s) (�150)
*Individual(s) (�100) - if member of sponsor
*please select as appropriate
Attendee Name(s) Email address Organisation
________________________ _____________________________ _______________________
________________________ _____________________________ _______________________
________________________ _____________________________ _______________________
________________________ _____________________________ _______________________
________________________ _____________________________ _______________________
Special mobility/dietary/other requirements
______________________________________________________________________________
Dates attending (please tick): 19 & 20 May 21 May
Please enclose a cheque, payable to 'Be The Change'
Account holder name: ___________________________
CHQ number: ______________ Amount: �__________
Please post completed booking forms and payment to the following address:
'Be The Change' - Suite 401, 502 Regent Street, London W1N 7LB
Terms: Bookings are not confirmed until payment is received, when a receipt and confirmation of booking will be sent.
Cancellations: In the event that the event is cancelled for any reason we will issue a full refund. Cancellations by participants more than 4 weeks prior to the event will attract a 25% admin fee. Cancellations by participants within 4 weeks of the event cannot be refunded. Special cases will be dealt with on merit.
Data protection: If you do not wish to be kept informed about future events, please tick: