Booking Form

I would like to register for Programm: ..........			on (date):.. ......................................
Name: ........................................................................................................................
Address .....................................................................................................................
Phone (home): ........................ (Business):: ............................. (Fax):............................
Date of Birth:...............

Vegetarian

I eat fish

I eat dairy products
Knowledge of English:

Good

Medium

Little
Only for Programme A (Traditional Echoes in Song and Dance), I am prepared to participate in

Dancing,

Singing (Please Tick)

If the above Programme is booked out, I would also be interested in registering for
Programme: ......................... on (date):......................................

Accommodation: I require:

Twin room with

Private Bath or

No Private Bath

Twin room, sharing with

Private Bath

No Private Bath

Single room

Essential

Preferred with

Private Bath

No Private Bath (Please Tick)
Please note: The number of single rooms is limited (for Galway/Cork final night in urgent cases only).
Single room in Galway, urgent (+30 Euro)

I would like to book the following additional nights:
On Inis Mór:	:...............	(number of nights) on	:.........................	(state exact dates)
In Galway:	:...............	(number of nights) on	:.........................	(state exact dates)
In Dublin:	:...............	(number of nights) on	:.........................	(state exact dates)

TERMS
Payment:
A payment of Euro 250 is to be paid on receipt of confirmation and invoice. The balance of the fee is to be paid 30 days befor the course commences. Payment, in Euro, should be made to Bank of Ireland, 43 Eyre Square, Galway, and loged into Bank Account code 90-38-08, Account No.: 24127321, Elizabeth Zollinger.

Cancellation:
On cancellation, a Euro 30 deposit fee plus percentage of the course fee shall be retained (31-59 days prior to commencement of course - 40%; 1-30 days befor commencement - 60%; notice not given - 100%)

Insurance:
Please note that liability is not accepted for injury, illness or loss af personal property. Participants ar advised to obtain insurance to their own requirements befor arrival.

AGREEMENT
I have read the Terms and Conditions of Booking and I agree to abide by them.

Signed: .......................................................... Date: ....................................................

Please return form to: Elizabeth Zollinger
Neumarkt 11, 8001 Zurich, Switzerland, Tel./Fax +41 1/252 09 18 (January - June)
Inis Mór, Aran Islands, Co. Galway, Ireland, Tel./Fax +353 (0)99 61424 (July - December)
eMail: info@irish-culture.ch