|Your Contact Details|
|Please tick if you do not want to receive marketing material and details of future courses by email or post.|
|*Date of Birth |
|*Names of all attending
|Do any of the participant have any medical conditions or learning needs? |
|If YES - please give details of any of the following along with the attendee name:
*Medication being taken / ADHD / Allergies / Asthma / Dyslexia / Epilepsy / Heart Conditions / Impetigo / Other
|*If you have any medication, including inhalers, please ensure that this is brought with you, even if you never use it.|
|Emergency Contact Details|
|Next of Kin |
|Emergency Telephone |
I have read and understand the declaration above.
- Participants must be water confident in light clothing and not suffer from any undisclosed medical or physical condition which might endanger themselves or others. NWC Instructors should be informed if there are any non-swimmers participating.
- For participants under 18 years, a parent or guardian must sign this form and in doing so authorises NSC staff or officers to approve emergency medical treatment should the need arise.
- I agree that NSC staff may photograph or video those taking part in any NSC activity and may use or store this media for training and/or promotional purposes in perpetuity.
- I also agree to the booking terms and conditions.
- Please note that all specialist equipment will be provided however, you should bring the kit listed on the confirmation letter.
- NSC will endeavour to provide you with an enjoyable and worthwhile course although there may be occasions when we cannot complete the whole programme, for example if wind, weather or other conditions dictate. In such cases, we will sign off as much as possible in your logbook and will offer future dates for you to return to complete your course.
|Cost||£120 / place|
|NOTE: Places will be held for 7 days, if payment is not received before then, the booking will be cancelled.|