Please print this out and sent it to :

The Scout Shop,
7 MacCurtain Street,
Cork,
Ireland,

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                    KILCULLY SCOUT ACTIVITY CENTER BOOKING FORM
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NAME OF GROUP :____________________________________________________________

LEADER :___________________________________________________________________

ADDRESS :__________________________________________________________________

         __________________________________________________________________

PHONE (HOME)__________________ (WORK)___________________

GROUP NUMBERS :

MALE :________     FEMALE :__________   LEADERS :__________ TOTAL :________

DURATION OF VISIT ______________________ NIGHTS

FROM :_____________________  TO :__________________

SECOND PREFERENCE :

FROM :_____________________  TO :__________________

TYPE OF ACTIVITY :

INDOOR   ________     PLEASE

OUTDOOR  ________      TICK   

SPECIAL REMARKS :

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________


SIGNED : __________________________________

DATE : ____________________________________




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