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Ripon Races - Days Out Leaflets

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Annual Badge Holder - Booking Form<br />

PLEASE COMPLETE IN BLOCK CAPITALS<br />

Name:<br />

Address:<br />

Post Code:<br />

Telephone Number:<br />

Email:<br />

If buying as gift name of person purchasing for:<br />

Type of Annual Badge:<br />

q Single Ladies q Single Gents £160.00<br />

Joint (must be living at the same address)<br />

q 1 Ladies & 1 Gents £240.00<br />

2 Ladies £240.00<br />

q<br />

q 2 Gents £240.00<br />

Junior. Please provide date of birth<br />

q Junior Girls q Junior Boys £100.00<br />

Guest Badge q £5.00<br />

Would you like to add a Ticket Wallet for an extra £1<br />

YES q NO q<br />

Cheque or money order enclosed £<br />

(Please make cheques payable to: <strong>Ripon</strong> Race Club)<br />

Alternatively to pay by debit/credit card enter your card details below:<br />

Card number:<br />

Last three digits on the Signature Strip<br />

Type of debit / credit card<br />

Start date<br />

Expiry date<br />

Issue no (switch only)<br />

PAY BY DIRECT DEBIT TO RECEIVE A 5% DISCOUNT –<br />

CALL THE OFFICE TO GET A DIRECT DEBIT FORM<br />

INTRODUCE A FRIEND AND RECEIVE A FREE GUEST BADGE<br />

Name of friend:<br />

Address:<br />

14<br />

!

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