Please note that this form has to be completed, signed and returned to the Cross Keys in order for your

booking to be secure.
(Please circle as appropriate)

Day & Date of Party:………………………………………………………………………

time of arrival.......................................................................................................................

Occasion:……………………………………………

Party Room: The Room at the Top (evening events-last orders at 11.30pm, vacate room by 12.20am)

Number of Guests expected:………………………………………………………

Name of Host(s):………………………………………………………………………

Company Name (if applicable):……………………………………………………

Email Address:…………………………………………………………………………

Contact Nbrs: Home:………………………………Work:……………………………………

Mobile:…………………………………………Fax:…………………………………………

No Room Hire Charge

Deposit: £200 (Private Rooms)

Paid: Cheque / Credit Card

Credit Card Name:…………………………………………………………………………

Credit Card No:………………………………………Exp Date:…………………

I am fully aware that you hold the right to bank my deposit in the event of cancellation, in the event

of damages caused, or if the minimum

spent is not met.
I have read and understood the terms and conditions for the use of the Room at the Top.

Signature:………………………………………Name:…………………………………

Date………………………………