www.mountaininstruction.co.uk - 07787 153 208
| Booking Form | Please
complete one form per person |
Title |
Date of birth | Confirmation will be sent to you upon receipt of a | ||
Full
name |
£50
deposit / day booked with your Booking Form. |
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Address |
The
balance fee is due 28 days before the course |
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start
date. If booking a course within 28 days the
|
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total
course cost is due with the Booking Form. |
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Post
Code |
Please
make all cheques payable to E W Kinnear |
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Tel.
No. (home) |
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| Mobile |
Total course cost | £ | ||
E-mail |
Deposit | £ | ||
Occupation |
Total enclosed | £ | ||
Medical
conditions, allergies |
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| I
fully accept that mountaineering, climbing and adventurous activities are inherently hazardous. I accept the risk of personnal accident, injury or death. |
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I
agree to abide by the safety instructions given.
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| I agree I am physically fit for my chosen course. | ||||
I
agree that cancellation, personal injury, loss or damage
insurance is not included. |
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Long
standing/recent injuries |
I
am over the age of 18 (unless accompanied by a participating adult). |
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I
accept cancellation must be in writing and acknowledged by Mountain Instruction. |
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I
accept deposits are non-refundable. If I cancel within 28 days and having paid the total course cost, 25% of the total course cost is refunded. |
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If
Mountain Instruction cancels, I will recieve a full refund or another course on a mutually agreed date. |
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Chosen
course |
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Agreed
course date(s) |
Signed | |||
Name(s)
of others on chosen course |
Date | |||
| Emergency contact | ||||
Previous
experience |
Name | |||
| Relationship | ||||
| Address | ||||
| Post Code | Tel. No. | |||
 |
Send
with cheque to: Edward Kinnear, 71 Lightburn Road, Ulverston, Cumbria, LA12 0BX 07787 153 208 edward@mountaininstruction.co.uk |