Longhurst Group Away Day


Name:

Job title:

Organisation:

Please book one of the following dates:
8th November
9th November
10th November

What are your dietary requirements?
Vegetarian
Gluten free
No dietary requirements

Please select where you would like to be collected from:
Birmingham
Nottingham
Boston
Nuneaton
Rugby
Bedworth
Grimsby
Walsall

Please select if you would like to sit at the front of the coach:
Yes
No

Please let us know if you have a disability:
Yes
No
If Yes, what support is required?