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OR please sign here

Dated

First Name

Surname

Title

Date of birth

Male or female

Address

Postcode

Home phone

Work phone

Mobile phone

Course title

Course dates

Course cost

Are you arriving on public transport? There are buses and trains, and we can do pick-ups where necessary

Do you have any special dietary requirements? Please also use this box for any additional comments or questions

I enclose a cheque or postal order payable to Paul Colley-Davies for the following amount together with this form, submitted by post

OR I will await for payment to be arranged via Paypal once Yellow Wood have received this form online, for the following amount

NB. The deposit for each person is £70 per course. For courses costing less than this, the full amount is payable upon booking. Any outstanding payments are due 4 weeks before the start of the course.

Declaration To be made by the person named above or agent, parent or guardian of the person named above.
I agree that I have read and accept the Yellow Wood Bushcraft terms and conditions. I recognise and agree that the courses offered by Yellow Wood Bushcraft contain an element of personal risk including injury and possible loss of life. That Yellow Wood Bushcraft Instructors and assisting instructors will not be liable to me now or at any time in the future for any loss, expense, damage or claim I might have against them for any damage to my property as a result of my participating in the course.That I am of sufficient physical fitness to participate in the course.

Click on 'book now' if you agree, or sign the form and date it if sending by post with cheque

All correspondence to Yellow Wood Bushcraft, Rose Tree Cottage, Ledgemoor, Weobley, Hereford, HR4 8RN
0845 226 1292 info@bushcraftadventures.com

For office use only:

Deposit received?

Deposit acknowledged?

Full amount received?

Arrival details sent?

Medical information
Please give information of any medical conditions which might affect your performance or safety on the course:

Do you suffer from any conditions currently requiring medical treatment? If yes, please give details of any prescribed medication:

Do you suffer from any known allergies (inc. allergies to medication)? If yes, please give details

Have you received a Tetanus injection in the last 5 years?

IN THE EVENT OF A SERIOUS INJURY:

Whom should we contact on your behalf?

Are they your next of kin?

ALL MEDICAL INFORMATION WILL BE TREATED IN THE STRICTEST CONFIDENCE