Course Booking Form

Please print off form, complete and send to us.
Use BLOCK CAPITALS throughout.

PERSONAL DETAILS

Title (Mr/Mrs/Ms)______________________________________

First Name____________________________________________

Surname______________________________________________

Age____________  Date of birth__________________________

Address_______________________________________________

Postcode______________________________________________

TELEPHONE NUMBERS (with codes)

Home_________________________________________________

Work__________________________________________________

e-mail_________________________________________________

NAME AND TELEPHONE NUMBER OF A PERSON WHO CAN BE CONTACTED IN AN EMERGENCY.

ROCK CLIMBING / MOUNTAINEERING EXPERIENCE
(outline experience)

MEDICAL CONDITIONS

If you have any medical history, condition or medications about which we should know please make sure you communicate this to us prior to departure. This information will be treated in the strictest confidence.

FEES

To secure a place on the course we will require a deposit of £70 (non-refundable) (See Terms and Conditions).

The balance is due no later than 14 days prior to commencement of the course.

SIGNATURE ____________________________________________________

DATE ___________________

Please send booking form along with a cheque made payable to...

Adventure Expeditions
3 Rosslyn Road,
Bath,
BA1 3LQ

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