Ticket confirmation

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REGISTER YOUR DETAILS

Please fill in this form with your details.
We do need this information before the event, so we can welcome you swiftly and safely on the day.

Full Name *

Home Address *

Home phone number *

Mobile phone number *

Email address *

Event of Interest *

Please select your event of interest.

What is your interest in this course?

Emergancy contact 1 (Home/Family) *

Must include, Name, address and phone number.

Emergancy contact 2 (Work/Friend) *

Must include, Name, address and phone number.

Doctors deatils

Must include, Doctor's name, address and phone number.

Medical Confirmation. *

I am well at the time of applying for this course.

If any symptoms become apparent please refrain from attending the course and tell us straight away so that we can open the place for someone else. Of course any money you have paid will be reimbursed.

Medical consent *

I agree for first aid to be administered by a qualified First Aider, which could include the use of an antiseptic, an appropriate cream and/or plasters.

Permissions *

I give full permission for photos/videos to be taken and used for display purposes and publicity, including our website and facebook pages.

Name

Ticket confirmation

TICKET CONFIRMATION

REGISTER YOUR DETAILS

THANKS AGAIN & SEE YOU SOON

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