Other UK Destinations Booking Form

You can pay on line via our secure paypal system by completing and submitting this Booking Form - A deposit of £50 is payable at the time of booking, the balance is payable prior to your holiday start date. If you would prefer not to pay on line, you can download this booking form and send to us together with your cheque made payable to Peak District Birding Holidays.

*Required field
Holiday Options
*Holiday Destination
*Preferred Holiday Dates
Alternative date if applicable
Number of people travelling	1 2 3 4 5 6 7 8
Number of single rooms required	1 2 3 4 5 6 7 8
Contact Details
*First or preferred name
*Surname
Date of Birth
*Address Line 1
Address line 2
*City
*Postcode
Country
*Telephone
*Email Address
Are you travelling?	Yes No

Name of Guests/Additional guests travelling
Title	Forename	Surname	Date of Birth

*How did you find out about us?	Search Engine Bird Watching Magazine Other
Any special dietary requirements
Any other additional information
Holiday Payments
*Amount you want to pay	Deposit - £50 Other Amount (Please enter below) Per traveller
Other Amount (If selected above)
*Image Verification
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*I have read and understand the terms and conditions and agree to abide by them.
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