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Polderslot event - Polderslot Witches brew - reservation form

I would love to come to the event witchesbrew on november 3^rd - november 5^th in Polderslot.

The costs for the event are:

€ 50.00 Adults
€ 40.00 Children uptill 12 years of age
€ 30.00 Children uptill 4 years of age
€ 27.50 daytrip Adults
€ 17.50 daytrip Children uptill 12 years of age
€ 7.50 daytrip Children uptill 4 years of age
€ 5.00 Surcharge for non members vca/sca

NOTE: Reserve only for people staying the same nights.
NOTE: Bring pillow, sleeping bag, bed-covers etc.
NOTE: If you live in the Euro countries: Pay your reservation before October 20^th 2023 to dutch account:
Vereniging voor Creatief Anachronisme, Almere,
IBAN: NL55 INGB 0001 2176 41,
BIC: INGBNL2A

Personalia
SCA-NAME
Mundane Name
Local group
Sleeping Options
Friday Night
Saturday Night
Feast
Other Options
Member
Participates in Heavy Fighting
Visible on web
Comments/remarks think about allergies, diets etc
Phone so that we can call you in need
email for confirmation of payments

I am also reserving for: (Age is only relevant for the children discount)

Possible other travel companions
SCA name	mundane name	age	feast	member	Fights heavy