Booking Contact Name *

First Name

Last Name

Participant Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Participant's Doctor *

First Name

Last Name

1st Emergency contact *

First Name

Last Name

2nd Emergency contact *

First Name

Last Name

Have you/your child suffered from any of the following: *

Asthama

Heart condition

Diabetes

Severe headaches

Allergies to medication

Fits, faintings or blackouts

Any other allergies

None of the above

Do you consent to photographs of the activities appearing on our website and social media pages? *

Yes

No

If the participant is under 18 years of age, by submitting this form, I (parent/guardian of the named person) give permission for the Principal of Tighnabruaich Sailing School to authorise administration of any treatment or medication deemed necessary. Further, if the case arises, I authorise the Principal to organise to take my son/daughter to hospital and give full permission for any treatment required in accordance with medical staff's diagnosis. I understand that I will be notified as soon as reasonably possible of the visit and any treatment administered.

I agree

By clicking the check box below, I, the participant or guardian of the participant declare to accept our Terms & Conditions and understand that the information provided above is used for the purpose of the booking and will be deleted at the completion of the course. *

I agree