Cancellation Form

Please complete and return this form only if you wish to withdraw from your contract with Us.

To:	Brilliant Bricks UK Limited Fountain Cottage, 21 Bell Road, Haslemere, Surrey, GU27 3DQ, United Kingdom Telephone: 07929 948823 Email: sarah@brilliantbricks.co.uk
I/We[] hereby give notice that I/we[] cancel my/our[*] contract for the sale of the following services.
Description of Services/Sessions to be cancelled:
*Ordered on / Received on[]:**
Name of Consumer(s):
Address of Consumer(s):
Signature of Consumer(s): (only if this form is notified on paper)
Date: