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I would like to come to this Alpha course (please tick):

Wednesdays 7.20-9.45pm, 28 Sept - 7 Dec 2011 (not 26 Oct)

Thursdays 9.15-10.30am, 29 Sept - 8 Dec 2011 (not 27 Oct)

Your Name:

Address:
Town:
County:
Postcode:
Country:

Telephone:
Mobile:

Email Address:

Dietary Requirements (please specify):

How many children?

0 1 2 3