Skill Share Booking And Consent Form

Name *

First Name Last Name

Are you a Newquay Forest School student? *

Yes No

PLEASE READ:

If you are a Newquay Forest School student please scroll to the bottom and click submit.

If you are not a Newquay Forest School student please fill you details accordingly in case of emergency and choose your payment options.

Email

example@example.com

Phone Number

The activities you will be taking part in may involve long periods of physical exercises and therefore it is important for any diagnosed activity to be declared prior to the activity. By signing this form you are agreeing to take part in outdoor activities with Newquay Forest School and understand that the activities will contain an element of risk.

(TICK BOX IF) I am aged 18 or over, have considered the risks involved in undertaking the activity including risk of bumps, scrapes, cuts, bruises and other injuries and agree to undertake the activity. I understand that Newquay Forest School accepts no responsibility for loss, damage or injury caused by or during participation in the activity, except where the loss, damage or injury was caused directly by negligence on the part of Newquay Forest School. I certify that I do not have any medical condition (including pregnancy) which might make it more likely that I be involved in an incident which would result in injury to myself.

Have you undergone surgery in the last 12 months?

Yes No

Have you been diagnosed with any condition which might prevent or restrict your involvement in the above activity?

Yes No

Are you currently taking any medication?

Yes No

If yes please state the medication you are taking:

Please record any current medical conditions, dietry requirments or allergies:

Please let us know an emergency contact, their relationship to you and their contact number:

e.g. Dan, husband, 0192837465

Signature - Please sign here by holding down your mouse button and drawing you signature to verify your consent to this booking... don't worry we won't be marking your signature on neatness!!!:

Payment

Skill Share (NFS STUDENT) Free

Skill Share (non NFS student) £ 20.00 GBP

Skill Share (first time taster session) Free

Total £ 0.00 GBP

Click 'Yes' if you would you like to be added to our mailing list for news of future events.

Yes No