Please complete the relevant parts of the form,
then print and return to us with your payment

Eastern Balloon Hire
Bower Hall, Western Road
Silver End, Witham
Essex
CM8 3SG

Pricing (all prices are inclusive of VAT)

	1-5 Adults		6-9 Adults	10 + Adults	In-flight Photo
Anyday, Anytime voucher (Weekdays, Weekends & Bank Holidays)	£145.00 each		£130.00 each	£120.00 each	£ 15.00 each
Weekday sunrise/sunset voucher Mon-Fri am or pm (excludes Bank Holidays)	£125.00 each		£125.00 each	£120.00 each	£ 15.00 each

		Flight Ticket Names	Gift Voucher Names
Please enter the names and approximate weight in Stones (St), Pounds (lb) or Kilos (Kg) for each person receiving a gift voucher. Examples: John Brown-12 St Judith Brown-110Lb George Smith-68Kg
Special Instructions / Additional information
Please enter the total number of gift vouchers and flight tickets required.		Adults: In-flight Photos
Please select the Flight time required.			Total Cost in £:

Your Details

Name:
Address:
Tel:
Payment by:

Card Type
Valid from:
Expiry date:
Card number:
Security No:
Issue Number (Switch only):