Booking form for a retreat at St Andrew’s

Name(required)

Surname(required)

Email(required)

Address(required)

Town(required)

Postcode(required)

Telephone number(required)

Date of arrival(required)

Time of arrival(required)

Date of departure(required)

Time of departure(required)

(required) I don't need an personal accompaniment

I wish to have a daily accompaniment by a sister

Have you been at St Andrew's before?(required) Yes

No

Emergency contact details. Name(required)

telephone number and email address of the emergency contact person

I send a deposit (non refundable) of(required)

(required) by BACS

by cheque (by post)

other:

Gift Aid(required)

Health and safety : If you know you would have difficulty managing stairs in the event of an emergency, please let us know in the message box below.Message