Lisa Jayne
Art Studio

Booking Form

Course Title ………………………………………………………………...

Date of Course ...………………………………………………………………

Please complete and return with a £50 deposit (non refundable), the balance payable 10 days before course commencement.

Payable to: Miss Lisa Jayne Bloomer
The Stables
Radford Farm
Radford
Near Enstone
Chipping Norton
Oxon OX7 4EB

Name ..………………………………………………………………..

Address ..………………………………………………………………..

..………………………………………………………………..

..………………………………………………………………..

..………………………………………………………………..

..………………………………………………………………..

Post Code ………………….

Telephone No. …………………………………………………………………

Mobile
Phone No …………………………………………………………………

Emergency …………………………………………………………………
Tel No.

E.mail ……………..…………………………………………………..


Allergies …………………………………………………………………

…………………………………………………………………

Other Course Interests

…………………………………………………………………………………………..

…………………………………………………………………………………………..

Experience in Art & Design

…………………………………………………………………………………………..

…………………………………………………………………………………………..

Age of child …………………………………………………………………
if applicable