PARTICIPANT INFORMATION FORM

First Name

Surname

DOB

Contact telephone number

Email Address

Title of course/event

Date of Course/Event

Please tick all that apply: Please tick all that apply: Asthma Angina Arthritis / Joint pain Back pain Chest pain Diabetes Epilepsy Echzema Hayfever Heart disease High Blood Pressure Migraines Vertigo Dietary requirements (Specify below) Allergies (Specify below) Mental ill-health (Specify below) Other (Specify below)

Additional details, dietary requirements or medical issues not listed above...

Next of Kin: Name

Next of Kin: Relationship

Next of Kin: Contact number

In booking onto this course I understand that Survival and Bushcraft Courses/Events can be both mentally and physically demanding. I will be provided with advice and guidance on how to keep myself and others safe; as a supervising adult I will support others to follow this guidance and advice. I also understand that alcohol and other recreational substances are not permitted on these courses / events. In booking onto this course I understand that Survival and Bushcraft Courses/Events can be both mentally and physically demanding. I will be provided with advice and guidance on how to keep myself and others safe; as a supervising adult I will support others to follow this guidance and advice. I also understand that alcohol and other recreational substances are not permitted on these courses / events. I Understand

Throughout the course/event we may take photographs and short video to use for marketing purposes on both our website and social media. Please indicate your preferences below. Throughout the course/event we may take photographs and short video to use for marketing purposes on both our website and social media. Please indicate your preferences below. I consent - Make me famous! Consent is fluid - ask me on the day! I consent but please only send them to me. I do not consent to be photographed or filmed.

Would you like to be added to our mailing list to hear about upcoming events and receive occasional offers? Would you like to be added to our mailing list to hear about upcoming events and receive occasional offers? Add me! No way!

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