The Gables
Multi Activity Holiday Centre
Booking Form
Date Of Visit From:_______________
To:_______________ Days Total:________
Transport Required: Yes/No
Departure Address:
One To One Care Required: Yes/No
(See Terms & Conditions)
I confirm I have read and accepted the terms and conditions of the Gables and
have disclosed all relevant information on the client profile forms.
In the event of a cancellation I shall be responsible for all cancellation
charges as set out in the terms and conditions
Signed:_______________________
Name:_______________________
Date:___________
Please make cheques payable to Choice Care Services
Telephone:
Guest Name
Client Profile
Ground Floor
Total Cost
Correspondence and Billing address:
Contact Name:
Telephone:
Contact Address:
Medication Chart Required
Client Profile Enclosed
Mileage Supplement
Deposit Enclosed