Please complete and return this form only if you wish to withdraw from your contract with Us.
Brilliant Bricks UK Limited
Fountain Cottage, 21 Bell Road, Haslemere, Surrey, GU27 3DQ, United Kingdom
Telephone: 07929 948823
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)
[*] Delete as appropriate