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Course Booking form

This form is secure and information given is treated in strict confidence.

Please fill in one form per participant. If under 18 years this form must be filled in and accepted by a parent or legal guardian.

N.B. If you have more than one participant in your group, on submitting this form please go back and complete all participant forms before paying at checkout.

 

Required fields= R  

Course title:

Country where course is to be held:

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Course start date:

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Course participant's first name:

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Course participant's surname:

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Date of Birth (DD/MM/YYYY):

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Parent/guardian (if <18 yrs):

Participant's Address line 1:

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Address line 2:

City:

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County:

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Postcode:

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Country:

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Mobile phone number:

Landline phone number:

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Email (if <18 yrs give parent/guardian's):

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Repeat email:

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How did you hear about this course?

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Please send occasional emails about future courses/offers etc.?

Medical information: (strictly confidential)

  

Blood group (if known):

NHS number (if known):

 

Specify any condition or special needs which might affect your performance or safety on the course:

Details of any condition requiring medical treatment:

 

Details of any allergies:

Emergency contact & phone number:

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Declaration:

The Terms and Conditions contain practical information that you will need to know when booking and/or attending a course.

It is therefore essential that all prospective participants read, understand, and agree to the Terms and Conditions.

In the case of participants under the age of 18, their parent or legal guardian (named above) must accept the Terms and Conditions and click the button below to provide consent for their child to attend the course.

By clicking on the ACCEPT button below you also declare that the information given above is correct and complete to the best of your knowledge. In the case of a parent/guardian you also declare that you understand the nature of the course and consent to your child attending.

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