Kenyon Bungalow Booking

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Which days and how long would you like to stay?(Required)

Arrive after 3:00pm and leave by 10:00am.

How Many(Required)

How many people will be staying at Kenyon bungalow? (max 10)

Please enter a number from 1 to 10.

Please tell us how many people within your party are carers

How many of the above are under 18?

Please enter a number from 0 to 9.

Date From(Required)

DD slash MM slash YYYY

Consent(Required)

I agree to the terms and conditions.

Family name or name of organisation:(Required)

Name of the point of contact for this booking:(Required)

Billing Details

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City County Post Code

Email(Required)

Daytime Tel No

Evening Tel No

Mobile

Different Lead Person

If the Lead person differs to the person named above, please include their details here

lead Name

First Last

Lead Address

Street Address Address Line 2 Town / City County Post Code

Lead Phone

Lead Email

How many guests are there within the party in total?

Guest Names(Required)

Activities during your stay.

Please provide us with your preferred activities. This helps us to organise your stay. We may need to alter your chosen activities due to volunteer or resource availability.

Summer visit

Apr-Oct inclusive - We provide a half-day activity per night stayed. If you would like more activities, the suggested donation rates will apply.

Winter visit

Nov-Mar inclusive - suggested donation rates will apply for all activities.

Mon am.

Mon pm.

Tues am.

Tues pm.

Wed am.

Wed pm.

Thurs am.

Thurs pm.

Fri am.

Fri pm.

Saturday*

*Regrettably, it will not always be possible to offer activities at weekends

Sunday*

*Regrettably, it will not always be possible to offer activities at weekends

Any other activity information

Please let us know any other information or fill in anything that you couldn't enter above.

Equipment

To make our activities accessible we have additional equipment available, if you think you require any of our equipment please speak to the office prior to your visit and indicate below.

Canoe/Paddling Back support

Supportive seating

Hoists

Beanbags/form supports

When planning your visit it is helpful to know how we can best support you. Please tell us here if you have any specific needs, or medical conditions, that may affect your safety on the water.

We are also able to provide the following in the bungalow. Please tick to indicate you would like the following:

Molift 150 personal hoist (trained users only)

Would you like to use our shower/changing trolley?

Shower chair

Fire Alarm listening device

Please note items included in the price of your stay.

Additional bedding requirements.

We can provide the following, please tick to indicate if you would like any of these items and enter the quantity required below.

Waterproof mattress protectors

Waterproof pillow protectors

Waterproof duvet covers

Water resistant duvets

Number of Waterproof mattresses

Number of Waterproof pillow protectors

Number of Waterproof duvet covers

Number of Water resistant duvets

Towels(Required)

We are able to provide x1 hand towel and x1 bath towel per person (inc in the price of your stay). Please tick to confirm you would/would not like us to provide the towels.

Yes - Please provide towels for our stay

No - We are bringing our own towels

Will anyone in your group:

have a guide/hearing dog?

Deposit

Price:

Balance Due

Price: £ 0.00

Credit Card

Cardholder Name

Card Details