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Christmas Dinner Sign up form
Please fill out this short form so that our team can get in touch and confirm your place, as spaces are limited
5
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1
Name
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First Name
Last Name
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2
Which homes would be your preference to have your Christmas Dinner?
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Please select all homes that work for you.
Codnor Park (Codnor)
Smalley Hall (Smalley)
Heanor Park (Heanor)
The Firs (Codnor)
King William (Ripley)
West Hallam (West Hallam)
Valley Lodge (Matlock)
Other
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3
Please let us know of any dietary requirement
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4
Contact Number
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5
Email
example@example.com
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