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05 October 2024
State am or pm
5
£8
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
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31
Start Date:
-
End Date:
-
Booking sessions and Courses
Session/ Course
*
Number of people
*
Please select a date first.
Name
*
Phone
*
Email
*
Participants name(s)
*
1st Emergency contact name
*
1st Emergency contact number
*
Consent:
*
Yes I consent
I have noted the arrangements and give permission for the above named to participate in the activities arranged. If it becomes necessary for the participant to receive medical treatment and the emergency contacts cannot be reached to authorise this, I hereby give my general consent to any necessary medical treatment and authorise the Leader-in-charge to sign any documents required by the hospital authorities. I will also notify the organiser if there is a significant change in health which might affect the participants ability to complete the
Total Price
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Payments
*
Bank Transfer (preferred) or cheque
Transfer money from your bank account.
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