October 26 Glass Fusion Workshop

October 26 Glass Fusion Workshop

Booking Form
Please complete name and age / adult for ALL individuals wishing to participate.

If you require more than 8 places, please email Rosie Robinson at rosie.pye@gmail.com to book a session.
1. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
2. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
3. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
4. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
5. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
6. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
7. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
8. Full Name of Individual Taking Part plus Date of Birth of Children. (Children should be 4yrs+ and MUST be accompanied by an adult minimum 1 adult to every 2 children)

First Name & SurnameDate of Birth (Children Only, for Adult, please put ADULT)
Which Session would you like to book for:

Which Glass Items are you going to make? (please type the total number for each option you wish to order.

Rows	Total Number Required for FIRST Option	Any Additional items (£8 each)
A. Hanging Owl
B. Brown Hedgehog
C. Hanging Leaf
D. Hanging Bauble
E. Bright Hedgehog
F. Ghost
H. Skull
I. Pumpkin

Name of Adult responsible for the booking. Payment details will be sent to this individual including information regarding the session and a reminder nearer the date.

First NameLast Name
Please supply an email for confirmation of your booking and to receive payment details.
example@example.com
Please confirm in order to secure the booking payment is required BEFORE Saturday 11th April. Payment details will be emailed on receipt of this booking request. The booking fee is fully refundable until closing date of 23rd October and 50% refundable between 23rd October and 28th October. Any cancellations after 28th October will not be eligible for a refund. Please contact us should you need to cancel last minute.
Payment Details:

Name: Ratby Library and Community Group

Sort Code: 09-01-28

Account Number: 74752640

Reference: Please mark your payment as GLASS followed by surname of the booking contact. E.g. "GLASS Robinson"

Payment must be received to confirm your booking.

Payment can also be made in cash or on card at the main library counter.
Should be Empty:

October 26 Glass Fusion Workshop

Please complete name and age / adult for ALL individuals wishing to participate.