Provincial Christmas Dinner 2025 - Individual Registration

Title *

First Name *

Last Name *

Phone

Email *

Do you want to book dining at event *

Yes

Menu - Starter *

Ham Hock Terrine

Roasted Parsnip Soup (v)

Main Course *

Herb stuffed Turkey Escalope

Spiced Potato & Soybean Tart (v)

Pudding *

Raspberry & White Chocolate Torte

Any allergies or special dietary requirements

Any special mobility needs

REQUEST TO SIT WITH

If you have an invitation number, please enter it here

Amount

£

Discount Amount

£

Gross amount

£

Payment Method

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

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Individual Registration