Canal Boat Cruises of Riley Green

Print out this form, complete it, send with your deposit to:-
Canal Boat Cruises,  37 Montreal Road, Blackburn, Lancashire. BB2 7BY

Holiday Details:-

Name

Boat name

Address

Maximum Number in party

I wish to hire for (please indicate)

Weekend break

Postcode

Midweek break

Tel no day

1 week

Tel no eve

Departing:-

Will this be your first canal holiday?

Yes/No

How did you hear about us:-

Friend/Recommendation

Yes/No

Internet

Yes/No

Waterways World

Yes/No

Canal Boat

Yes/No

Seen our boats on the canal

Yes/No

Yellow pages

Yes/No

Other (please specify)

Payment Details:-

Deposit 25% of total hire fee to nearest pound

£

Strongly Recommend

Payment for cancellation scheme 4% of total hire cost

£

I enclose remittance for the total amount now due

£

Passenger details:-

Name

Address

Age if under 20

1

2

3

4

5

6

7

8

Declaration:-

I am over 20 years of age.
I have read and agree to be bound by the Conditions of Hire.

 Print Name …………………….         Signature ………………………   Date ……………….