Manjedal Activities Centre- Bookings Form

Contact Information

Group:

Person in Charge:

Postal Address:

Suburb:

Post Code:

Telephone

Home:

Work:

Fax:

Mobile:

Email:

Accommodation

Date From:

Select Date Time (24HR):

Date To:

Select Date Time (24HR):

Please indicate
location(s) required:

Gilwell
The Youth Centre
The Lair
The Lodge
Campsite
Day Visit
Other (please specify):

Please indicate numbers:

Male:
Female:
Disabled:
Total:

Options

Catering:

Manjedal | Self | Send Catering Info Package

Activities, Facilitators & Equipment

Select Activity:	Date:	Time:	Facilitator (if known):
	Select Date
	Select Date
	Select Date

Extra Facilitator Hire

Select Activity:	Date:	Time:	Facilitator (if known):
	Select Date

Extra Equipment Hire

Select Activity:	Date:	Time:	Number Required:	Other Details:
	Select Date
	Select Date

Security Code:

The code in the image on the right must be entered into the box below for verification purposes.

By submitting this form you agree to the Terms, Conditions and Prices of Manjedal Activities Centre. Shortly after receipt of this email, you will receive an Invoice for a deposit. Bookings not confirmed within 14 days will be made available to other campers.

Mail: Manjedal Activities Centre, P.O. Box 120, Byford, 6122 Email: manjedal@scoutswa.com.au

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