Fifty Lounge Restaurant BOOKING FORM

Date of Booking ..........................................................................

Date of Function..........................................................................

Lunch  Dinner 

Time of Arrival........................ Time to Dine............................

Number of People Dining............................................................

Organiser’s Name........................................................................

Organiser’s Contact Number......................................................

Organiser’s/Company Address...................................................

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Postcode.................................... Tel.............................................

Fax............................................. Mobile......................................

E-mail............................................................................................

Deposit = £50 lunch / £100 dinner (non refundable)

Total Deposit £......................... Date Paid.................................

Payment Method...................... Staff .........................................

Card Holders Name.....................................................................

Card No    

Valid From ………..Exp Date…….....Issue No …….Security No……..

Cardholders Signature ………………………………...............

(cheques made payable to ‘Fifty Lounge Restaurant’)

Any cancellations at less than 24 hours notice will be charged in full.

Any damages / breakages must be paid for in full .