Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone Number 1

Phone Number 2

Allergies

Please state any dietary and environmental allergies here. Only state allergies and not preferences here.

Dietary Requests

We do our best to fulfil these requests, we are not able to make any guarantees. If we are unable to meet these requests we will let you know in advance of the course.

Any medical conditions we should be aware of and how should we respond in case we need to act on this.

Emergency Contact

Please provide a name and telephone number.

Filming Consent

A film crew will be present and will be filming for a documentary. Anyone attending the course will be asked to fill in a contributor consent form giving their permission to be shown on film.

What is your profession?

The answer to this question will be shared with the TV show producer.

What are you hoping to learn?

The answer to this question will be shared with the TV show producer.

How are you hoping to incorporate what you have learned on the course on your return home?

The answer to this question will be shared with the TV show producer.

Notes

I have read, understand and fully agree to the terms and conditions for this booking.

Cancellations: No refunds given for any reason 30 days prior to the course starting. Before this full refunds will be made minus a £30 administration fee. You may transfer your booking to another person, but we must be informed of this change including full contact details of the new student 48 hours prior to the start of the workshop.

Thank you!

We will be in touch very soon to discuss this application with you.

Please do not hesitate to email us if you have any questions.

cpatel@domesticatedmanners.com

Chicken Camp Application

EMAIL chirag@chiragpatelconsulting.com

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