Booking Form

*(denotes required field)

First Name: *

Last Name: *

E-Mail Address: *

Address1 *

Address2

Town / City *

Post Code *

Region

Country

Mobile Phone Number *

Your Organisation (if any)

Course Title *

Course Start Date *

Course Duration (days) *

Dietary Requirements

Medical Conditions

Do you take any form of medication? Please give details...

Gender *

Female Male Non-specified

Date of Birth *

Next of Kin

Name *

Phone Number *

Disclaimer

By ticking this box I confirm that I accept David Key's Terms & Conditions. and reiterate that:

• I am physically and psychologically fit for the course I have chosen an I have disclosed any medical conditions that may effect my safety, or the safety of group, or the group leaders;
• I appreciate that my course may be hazardous by its nature and I accept that a certain element of risk is inherent in outdoor activities;
• I understand that if I choose not to take the safety advice given to me by the course leader, I am personally liable for the outcome.
• I have taken out appropriate insurance relevant to the course I have chosen.

I accept *