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ski angels training form

Name of Course & Location

Course Date

YYYY

Personal Details

Name

First Name

Last Name

Date of Birth

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile Number

Emergency Contact Details

Name

First Name

Last Name

Number

Medical Details

Name of Doctor

First Name

Last Name

Doctor's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

The answers to the following three questions are confidential, but we need to know this information so that we can best adapt the course to your needs:

Do you have any medical conditions that we need to know about, that may affect your participation in the course, for example, back or muscle pain. If so please give details.

Do you have any psychological conditions that may affect your participation in the course, for example anxiety. If so please give details.

Do you have any specific learning difficulties such as dyslexia, or slow processing that may affect your ability to learn on this course. If so please give details.

Do you have any dietary requirements. If so please give details

Declaration

I agree that the information given above is correct to the best of my knowledge; If there are any changes to the above information, I will let the course organiser know as soon as possible; I consent to the taking of photographs or video of me during the training course, for the use of marketing and training purposes; I agree to abide by any Ski Angels rules and policies that are relevant for this course; I understand that there is a small element of risk in any outdoor training environment.

I agree

Digital Signature

Date

YYYY