Christmas Day Meal Referrals

Please enter details for the guest first

First Name (required)

Surname (required)

Guest's Contact Number (required)

Guest's Date of Birth (if known) - format dd/mm/yyyy

Gender (This will help us gift choices)

MaleFemalePrefer not to say

Emergency Contact Name (required) - **CHRISTMAS DAY ONLY**

Emergency Contact Number (required) - **CHRISTMAS DAY ONLY**

Dietary requirements?

Known Allergies?

Transport required?


Does guest have mobility aids/wheelchair/pushchair?


Anything else we need to know?

Guest's interests

I'm referring myself YesNo

If not self-referred, please complete fields below

Referred by (Name) (required)

Your Email (required)


Your contact number

How much is?

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I agree