Children aged 2 - 3 years ...........

Children aged 3 - 4 years..............

Children aged 5 - 8 years..............

Children aged 9 upwards...............

Date of Dining...............................

Vegetarian/special diets requests.........................................................

Number of Sweet(s) Required for Pea & Pie Supper ............................

We Require a deposit to secure all bookings of £10.00 per person for Sunday Lunch and Christmas Lunch, £4.00 per person for Cream Teas and £5.00 per person for Afternoon Teas and Pie and Pea Suppers

I enclose remittance of £................made payable to Peak Rail plc.
or please debit my Mastercard/Visa/Switch card

OR Please debit my Switch/Visa/Mastercard Card

No........../........../........../..........

Start Date ................

Expiry Date................

Issue Number (Switch Only) ........

Security Number ..................... (The last 3 numbers on the back of the card)

Card Holder's Name.............................................................

Card Holder's Signature..............................................Date....................


Please send this form to :-

Peak Rail
Matlock Station
Matlock
Debyshire
DE4 3NA


Telephone 01629 580381

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