To reserve your pitch please
send £10.00 non returnable deposit with
Stamp addressed envelope
Please put membership number on back of cheque
To: Mr Barry Smith, 16 Belle Vue Road, Earl Shilton, Leicestershire,
LE9 8AA
I enclose cheque for £_______ (Payable to Central Counties Region C&CC)
Date of arrival:- _______________
Date of departure:- _______________
Total Number of Nights:- _____
Number of adults:- _____
Number of extra adults :- _____
Name _________________________
Address _________________________
__________________________
Membership number:- _______________
DA or Section :- ____________________
Type of Unit :____________________
Telephone No _____________________
E-Mail Address
____________________