Lead-Name (required) Membership Number, If you are not a member please type non (required) Email (required) Please enter your mobile number (if no mobile please enter landline number) (required) How many Seats for this Excursion? Please Select123456 Please tell us the name (s) of additional people on this booking. This day out includes a meal. Please choose from the following: First Diner Choices - Name - Hors d’oeuvres —Please choose an option—Pâté en croute (Farmhouse Pâté baked in crust)Terrine de poireaux (Leek Terrine, Dijon and truffle vinaigrette) Plats —Please choose an option—Coq au vin (Chicken in red wine sauce, pomme purée, pancetta, garnishes)Chartreuse de legumes (Vegetable farce, truffled spinach, pommes duchesse) Dessert Tarte au citron (Lemon Tart, raspberry coulis) Second Diner Choices - Name - Hors d’oeuvres —Please choose an option—Pâté en croute (Farmhouse Pâté baked in crust)Terrine de poireaux (Leek Terrine, Dijon and truffle vinaigrette) Plats —Please choose an option—Coq au vin (Chicken in red wine sauce, pomme purée, pancetta, garnishes)Chartreuse de legumes (Vegetable farce, truffled spinach, pommes duchesse) Dessert Tarte au citron (Lemon Tart, raspberry coulis) Third Diner Choices - Name - Hors d’oeuvres —Please choose an option—Pâté en croute (Farmhouse Pâté baked in crust)Terrine de poireaux (Leek Terrine, Dijon and truffle vinaigrette) Plats —Please choose an option—Coq au vin (Chicken in red wine sauce, pomme purée, pancetta, garnishes)Chartreuse de legumes (Vegetable farce, truffled spinach, pommes duchesse) Dessert Tarte au citron (Lemon Tart, raspberry coulis) Fourth Diner Choices - Name - Hors d’oeuvres —Please choose an option—Pâté en croute (Farmhouse Pâté baked in crust)Terrine de poireaux (Leek Terrine, Dijon and truffle vinaigrette) Plats —Please choose an option—Coq au vin (Chicken in red wine sauce, pomme purée, pancetta, garnishes)Chartreuse de legumes (Vegetable farce, truffled spinach, pommes duchesse) Dessert Tarte au citron (Lemon Tart, raspberry coulis) I wish to get the coach at: Please be aware the departure points are Herne Bay, Wincheap Park and Ride or Medway Services - London Bound Side. FOR MEDWAY SERVICES Please provide the make and registration number of the vehicle that you will be using on the day (required) Departure times are as follows: Herne Bay: 08.45hrs Wincheap Park and Ride: 09.15hrs Medway Services (depart): 10.00am Any Additional Information including dietary requirements where applicable Members may book for this trip with a £25 per person non refundable deposit. The balance of payment will be due by the 1st August. Please tick the box if you wish to avail yourself of this offer and send £25 per person instead of the full amount. Yes Once the form has been submitted you will be advised about payment. If you do not receive the automated response within 24 hours please call the Chairman on 07842 124094 or send an email to treasurer@silverphoenixtc.com