ABN 19 881 582 192

CLIENT NAME : ………………………………………………….

ADDRESS : …………………………………………………………

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TELEPHONE :   HOME : …………………………………………

                             BUSINESS : …………………………………….

                             MOBILE : ……………………………………….

FAX : ………………………………………………………………….

E-MAIL : ……………………………………………………………..

DATE OF FUNCTION:………………………………………………

TIME OF FUNCTION : ……………………………………………..

NUMBER OF GUESTS : …………………………………………….

I HAVE READ, AND AGREE TO ABIDE BY THE TERMS AND CONDITIONS OF THE CONTRACT AS SET OUT BY CELEBRATIONS AFLOAT.

SIGNATURE : …………………………………………………………

Bank Details :    ANZ Bank, Cnr Bayview Str. & Lae Drive, Runaway Bay

Account Name : Broadwater Celebrations (Pty) Ltd

BSB :                  014 696

Account No.:      4901 52073