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0121 647 7151

Advance booking recommended

Secure Online Voucher Purchase Form Luxury Cruising Restaurant
TITLE

FIRST NAME

LAST NAME

ADDRESS POSTCODE

TELEPHONE

MOBILE

EMAIL*

Please tick if would require an Email confirmation * Make sure you give us a valid email address
MEAL

IF 'SPECIAL' GIVE DETAILS
VOUCHER VALUE

Only complete if for specific value in multiples of £5

DRINKS EXTRAS

HOUSE WINE @ £13.95 per bottle to value of

  CHOICE OF WINE FROM LIST to value of
  SPECIFIC VALUE OF WINE + DRINKS
SPECIAL EXTRAS FLOWERS to value of (from £10)
  BIRTHDAY CAKE to value of (from £20)
  DECORATIONS to value of (from £10)

NUMBER

people  

CAPTAINS TABLE

Carries a surcharge of £20 for bookings of less than 4 people.
Name & Address of the person receiving voucher if you require us to post direct to them.
NAME
ADDRESS POSTCODE
Do you want the Gift Voucher to be sent in a Gift Card?  This costs £3 extra.
We undertake to NOT pass this information to a third party. Please tick the box if you do not want to receive any promotional offers in the future.
Payment Options:
Please note - We will call you to collect payment as soon as we can.