23rd April 2014 Supporting Breastfeeding Mothers: A day with Nancy Mohrbacher Booking Form Venue: Northcliffe Church Hall, Hall Royd, SHIPLEY, Yorkshire BD18 3ED First Name Surname Address First Name Surname Enter address here Please note, the WHO code, Global Strategy, WHA resolutions prohibit individuals employed by infant feeding manufacturers from providing any breastfeeding education to mothers. Breastfeeding LENS Limited events may not be used to support such work. Postcode Telephone Email Enter postcode here Enter phone number here Enter email here Please indicate your Occupation Enter occupation here I am a MotherBaby Together Peer Supporter* Yes/No Breastfeeding LENS is delighted to be able to offer this event at a special low price. The day fee includes all refreshments and lunch. This includes vegetarian options. Masterclass only includes refreshments. (Please click to choose the relevant boxes) *Exclusive rate for MotherBaby Together Peer Supporters only Day 9.15am-3pm Day + Masterclass 9.15am-5pm Masterclass only From 3pm-5pm TOTAL PAYABLE £35 select £30 select £50 select £45 select £20 select £15 select select select Payment method: Choose payment method here ACCOUNT NAME: Breastfeeding LENS Ltd - SORT CODE: 40-38-22 - ACCOUNT NUMBER: 21488996 Please complete & send this booking form to: events@breastfeedinglens.co.uk Booking after 23rd March 2014 add £10 per person · · · · · · · · · Payment may be made by bank transfer (please give delegate name as your BACS reference). This is our preferred option. Where possible we will email your receipt. Paper receipts only with a stamped addressed envelope. If you require an invoice please complete & send this booking form(s) to: events@breastfeedinglens.co.uk Booking after March 31st at the discretion of the organisers. Cancellations will only be considered if requested in writing and received by March 20th 2014. An administration fee of £20 will be charged. No refunds will be given after this date. Substitutions will be accepted at any time. (If you require to pay by cheque; cheques are payable to Breastfeeding LENS Limited. Please return your booking form & cheque to: Breastfeeding LENS Limited, 11 Priory Gardens Swanwick Alfreton Derbyshire DE55 1DU) Email enquiries to: events@breastfeedinglens.co.uk We would like to send you more information about future Breastfeeding LENS events, you may opt out at any time. If you wish to opt out please indicate here choose ✄ -------------------------------------------------------------------------------------------------- Cut here and keep -------------------------------------------------------------------------------------- Supporting Breastfeeding Mothers: A day with Nancy Mohrbacher. Venue: Northcliffe Church Hall, Hall Royd, SHIPLEY, Yorkshire BD18 3ED I have booked and paid for choose Breastfeeding LENS Limited Email enquiries to: events@breastfeedinglens.co.uk © Breastfeeding LENS Limited 14.2.2014 Date sent 23rd April 2014 Click here to enter a date→