Lorrin Golf - Golf Academy Payment Form

 

 

We recommend that you print this Payment Form before completing in blue or black ink.

You may also complete the form electronically before printing. The final section of the form must however be completed by hand.

Payment Information
• We accept Switch, Delta, Mastercard, American Express, Visa and Diners Card
• Payment may also be made by Cheque (made payable to Lorrin Golf Trust Account).

Preferred method of payment (please tick)

Credit Card    Debit Card   Cheque

         

Card Details

        

Name as it appears on card

      

Address

      

Post/Zip Code

      

Card Number

      

Type of Card

      

Expiry Date

/ (Month / Year)

      

Issue Number

      

Security Code

 (the last 3 digits on the reverse of the card)      

 

 

      

LG Insurance Cover
£20 per person for one week of travel

 £      

Insurance Details

        
Please print this Payment Form before leaving the page as information already input may be lost.
         

Total Paid

 £      

 

         

Please tick this box to confirm you have read, understood, and accept Lorrin Golf's booking Terms and Conditions.

Please print this Payment Form before leaving the page as information already input may be lost.
         

Signed
(electronic signature not valid)

      
 

Printed Name

      

Telephone No

      
 

 

Fax

Please fax the completed form to:

(+44) 141 357 3461

Post

Alternatively, post to:

Lorrin Golf,
31 Beechwood Drive,
Glasgow,
G11 7ET
United Kingdom