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| Please print out and complete one form
person in a format that can easily be read. |
| Course Title: |
Course date: |
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| Applicants Name: |
Age on course date: |
| Applicants Address: |
Telephone No.(s): |
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| PostCode: |
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| Email Address: |
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| Who should we contact
in case of an emergency (name and address)? |
Name: |
| Address: |
Telephone No.(s): |
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| PostCode: |
Your Relationship with contact: |
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| Previous kayaking qualifications/brief
experience/expectations: |
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| Any Medical conditions
which might effect your participation
in the course: |
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Return the form to the address below with a £30 deposit
for a two day course or £20 for a one day course (cheques
should be made payable to M I Wilby). If you do not have an
email address please include an A4 SAE with your booking form
to ensure you receive the course details. Balance due on arrival
to the course.
I confirm that I wish to attend the course as laid out in
the course information. |
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Return to: Training 4 Outdoors, c/o
Martin Wilby, Chellow House Cottage, Kingsley Drive, Birkenshaw, Bradford. BD11 2PB. |
