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| Full Name: |
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Age: |
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| Address: |
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| Tel No: |
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Email Address: |
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Confirmation by Email:
(Please write clearly) |
Yes / No |
| Residential Courses (please circle): |
| 2 Day Weekend | 5 Day | 7 Day | 14 Day |
| NON-Residential Courses (please circle): |
| 2 Day Weekend | 5 Day | 7 Day | 14 Day |
For residential courses accommodation is at the Coverack Youth Hostel.
If you choose a Non-Residential course we can arrange accommodation for you if you so wish. |
| Accommodation Required (please circle if applicable): |
| Camping | Caravan | B&B | Cottage | Flat | Hotel |
| Your Windsurfing Level: |
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Course Date: |
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| (Novice - RYA 1, 2, 3, 4, 5, Fast Forward - RYA Junior 1, 2, 3) |
| I require use of a wetsuit: |
Yes / No |
I would like to buy wetsuit boots (£28.00 per pair): |
Yes / No |
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Shoe size: |
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Please enclose a made payable to Coverack Windsurfing Centre.
For all Weekend courses is required at time of booking.
Please include the cost of the wetsuit boots @ £28.00 if applicable. |
| Deposit enclosed: |
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I confirm that I have read and agree to accept the booking conditions.
I declare that, to the best of my knowledge, I am not suffering from any illness that would prevent me from taking part in water activities and that I am physically fit to participate in the course/activities involved. I can swin 50 metres/I am water confident. |
| Details of any medical treatement or prescribed drugs being taken (if none, please write none): |
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| Signed: |
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Date: |
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Parent or Guardian name
(if under 18): |
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Signed: |
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| Telephone Day: |
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Telephone Evening: |
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| Doctor: |
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Telephone: |
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| It is a legal requirement, as per the Activities Licencing Act, to have a completed Next Of Kin form. |
| N.O.K. Full Name: |
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| Address: |
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| Telephone Day: |
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Tel Evening: |
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| Please send this form (including a cheque for the deposit) to:
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Coverack Windsurfing Centre
Cliff Cottage
Sunny Corner
Coverack
Helston
Cornwall
TR12 6SX
Tel: +44 (0)1326 280939
Email: windsurfing@coverack.co.uk |