Berwick Cottage Booking

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How long would you like to stay?

Date From(Required)

Bookings are from 4pm Thursday to 10am the following Thursday. Currently available start dates are highlighted.

DD slash MM slash YYYY

Consent(Required)

I agree to the terms and conditions.(Required)

Family name or name of organisation:(Required)

Name of the point of contact for this booking:(Required)

Billing Details

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City County Post Code

Mobile

Landline

Email(Required)

Different Lead Person

If the Lead person differs to the person named above, please include their details here

Lead Name

First Last

Lead Address

Address line 1 Address line 2 Town / City County Post Code

Lead Phone

Lead Email

Party Members

Please include the full name of all other members of your party (if known)

How many guests are there within the party in total?

Please tell us how many people are carers within your party

Guest Names(Required)

Animals(Required)

I am bringing one pet Dog

I am bringing an Assistance Dog/s

I am not bringing an Dog

Assistance Dogs - Assistance dogs welcome. Pet Dogs - One well behaved dog welcome. Please note, if you have more than one pet dog please call us directly prior to completing your booking 01692 630572. Terms and Conditions apply * Please see Animal Policy on webpage for details.

Would you like a Motor Cruiser Trip at our centre in Neatishead?

Yes, I would like the boat trip

No, I do not want the boat trip

(This is included with your booking, the boat trip will be from our base at Neatishead at 1.30pm on Monday afternoon of your stay). Please meet us at The Nancy Oldfield Trust, Irestead Road, Neatishead NR12 8BJ at 1.30pm on the Monday of your stay. * Please note, if you need to cancel the boat booking please call us as soon as possible 01692 630572

How many people in the group have a disability(Required)

Please enter a number from 1 to 6.

When planning your visit it is helpful to know how we can best support you. Please tell us here if you have any specific needs, or medical conditions, that may affect your safety on the water.

Requirements

If you require any of the following, please tick (check) each item listed below. Please note there is no additional charge.

Requirements

2x Waterproof Pillows

2x Waterproof Duvets

Shower wheelchair/commode (tilt-in-space)

Height adjustable perching stool

Stainless drip stand

Urine bag stand/holder

Zimmer frame with wheels

Manual wheelchair (standard adult size)

Child's highchair (able bodied)

Manual hoist (slings not provided)

Baby intercom

Will anyone in your group:

be using sharps, swabs or dressings?

have a guide/hearing dog?

be bringing or using specialist equipment not supplied by us?

Towels(Required)

Yes - Please provide towels for our stay

No - We are bringing our own towels

We are able to provide x1 hand towel and x1 bath towel per person (inc in the price of your stay). Please tick to confirm you would/would not like us to provide the towels.

Details for any specialist equipment:

Bursary Funding

Yes

I have submitted a form but not had approval yet

I do not need bursary funding

Have you had a bursary approved for this trip? Please note, if your bursary application is in process you will be notified once it has been approved, and will receive a revised confirmation letter.