BOOKING FORM

NAME:……………………………..................................................………………………………......

ADDRESS:……………………………………………………….......................................................

....................................................……………………………………………………………………………

DATE OF BIRTH:…………………..................…..    AGE:……...........................………………

TELEPHONE NUMBER:……………………………………................................................………

DAYTIME TELEPHONE NUMBER:……………………………….............................................

MOBILE NUMBER:………………………………………………….................................................

EMAIL ADDRESS:…………………………………………………..................................................

I have included a cheque for £30.00 deposit ( please tick box ) 

I have made payment online via PAYPAL ( please tick box ) 

I have read and fully understand the terms and conditions and understand that unless the competition is cancelled this is a non returnable deposit ( please tick box )

Please make cheques payable to NEW IMAGE FITNESS LTD

SIGNED:……………………………..     DATE:……………………...............................................

Please print out and post completed forms to:- 

New Image Fitness Ltd, 1 Paradise Lane, Warley, Halifax, HX2 7RQ