CL Jazz Booking Form

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To enrol on a CLJazz course please print out and complete this form and send to

Bob Hitchings, 10 Ashleigh Terrace, bridgwater, Somerset, TA66AT

with a £50.00 deposit made to CLJAZZ

or you can email the information to

bobhitchings@enterprise.net

NAME ..................................................................................

ADDRESS............................................................................................................................................................

POST CODE ............................................. TELEPHONE .................................................

EMAIL: ..................................................................................................

INSTRUMENT (S): ...............................................................................

SPECIAL DIETARY REQUIREMENTS: ...........................................................................................................................................................

ANYTHING ELSE WE NEED TO KNOW? (MEDICAL ETC)............................................................................................................................