First name
Last name
Gender MaleFemalePrefer not to disclose
Address Line 1
Address Line 2
Town/City
Postcode
Email Address
Telephone Number
Activity
Activity Date
In the event of an emergency:
Next of Kin Name
Next of Kin Telephone Number
Further Information: Do you give permission for suitable photographs taken on the activity to be used for the purposes of PR for Mountain Sojourns? YesNo
Health Declaration - PLEASE READ CAREFULLY BEFORE SUBMITTING
1. If you have any known allergies or medical conditions that may affect your ability to exercise, please inform your instructor before you start your activity and give brief details.
2. If you have any regular medication such as inhalers etc. please make sure you carry them with you and let your instructor know.
3. Should I develop a condition that affects my ability to exercise, I will inform my walk instructor immediately and stop exercising if necessary. I take full responsibility for monitoring my own physical condition at all times.
It is understood and agreed that individuals participate at their own risk and Mountain Sojourns will do all in its power to run the activities as advertised, though weather conditions may entail a change of program for Health and Safety reasons.
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