2012 BOOKING FORM

Card type, please tick: □ Visa □ Electron □ MasterCard □ Maestro

Card Number:

Start date: Expiry date: Issue No: Security code (3 digits on back of card):

Name on card (PLEASE PRINT): ___________________

Card holders Signature: ______________________________

Fax/post/email your completed form using the details below.

FIA, Castlewood House, 77-91 New Oxford Street, London, WC1A 1PX

Tel: 020 7420 8582 Fax: 020 7836 3088 Email: georgia@fia.org.uk website: www.fia.org.uk

NAME:

CLUB/COMPANY:

FIA NO.:

Event details:

How many people?

(Please provide

names, special dietary

requirements and

number of

vegetarians)

FIA FIBO NETWORKING EVENING – 19TH APRIL 2012

(12 minute taxi journey between Intercity hotel Essen and CASINO Zollverein,

Essen 53, 45128 Essen)

19.30 – Pre dinner drinks at the CASINO Zollverein, Essen

20.00 - Dinner and Drinks at CASINO Zollverein, Essen

The cost includes the Networking reception from 19:30 – 20:00 followed by a,

3 course meal which includes beer, wine, soft and hot drinks with your meal

and to continue up until 22:00.

Total package cost £75 (includes selected drinks from 19:30 – 22:00 admission and a set 3

course meal)

After dinner guests are welcome to stay on in the bar area of the restaurant for

further networking opportunities outside of the FIAs specially selected package.

Total payable to FIA:

£

Credit/Debit Card Please enter your details below.

Cheque Please make cheques payable to “Fitness Industry Association Ltd” and post

asap to the address below along with this booking form.