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Name:required
Email Address:required - PLEASE TYPE CAREFULLY:
What is your age? required
What is your address incl POSTCODE
Home Phone: required
Work Phone
Mobile
Which Boat would you like.required
If you require more than one,
give details in message box below.
If You have chosen an Electric Boat,
do you have a preferance.
What Date do you require. required
Alternative Date
Start Time (not before 10 am)required
Finish Time (not after 6 pm)required
How many in your party including yourself (MAX 12)required
Any further information or questions you wish to ask us.
Have you read and do you agree to our Conditions of Hire. required YES
NO
We are happy for you to use this form as a general enquiry
but if you wish to make a booking,
or have already made a booking,
please indicate here. required 		ALREADY BOOKED BY PHONE
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muggins Bev., Chris., and Kathy Shields
Chertsey Meads Marine
The Meads - Chertsey
Surrey ---- KT16 8LN
TEL/FAX: 0870 411 9888
 sparky


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