Valley Campus online booking form

Valley Campus Online Booking
Group Name
What is the purpose of your program?
What resources do you require to help run the program?
Please provide a brief outline of your program
Preferred arrival date

DayMonthYear
Preferred departure date

DayMonthYear
Alternate arrival date

DayMonthYear
Alternate departure date

DayMonthYear
Arrival time

:HourMinutesAM/PM Option
Departure Time

:HourMinutesAM/PM Option
Estimated number of people attending:
Children < 15 years
Adults
Adult/instructor to particpant ratio
Breakdown of males and females
Will you need access to the kitchen?
Does your group have Public Liability Insurance?
Does your group have a Risk Management Plan?
Contact Details:
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

PostcodeCountry
Phone Contact
E-mail
Any other details?
Should be Empty: