BOOKING FORM
Please read the booking conditions before completing the booking form below.
By completing the booking form you acknowledge that you have read and agree with the booking conditions.


NAME (Mr, Mrs, Miss, Ms) ______________________________

 ADDRESS ___________________________________________

 _____________________________________________________

 ____________________________ POST CODE _____________

 TEL NO: _________________ DAYTIME NO: ______________

 AGE ____________ DATE OF BIRTH _____________________

 

COURSE REQUIRED

 COURSE NAME ___________________ CODE NO __________

 DATE ________________________________________________

 EXPERIENCE: Please indicate level of performance and list awards

 held ___________________________________________________

 _______________________________________________________

 Details of any physical disabilities or allergies ___________________

 Do you have any medical condition of which we should be aware?

 Yes / No

 If yes please give details __________________________________

 ______________________________________________________

 This may not necessarily exclude you from a course but we need to be

alert and able to respond to your condition.
Should you be unsure of your fitness to attend a course then
please discuss this with your Doctor.

 Name and Telephone Number of a person we can contact in an

emergency ______________________________________________

 Interested in RYA membership?

 I am able to swim 50 metres in light clothing and am physically fit to
take part except for any medical problems which I have declared above.

I understand that:

 1.The deposit is not refundable once a place has been confirmed, unless the course is cancelled by Lymington Town School of Sailing & Powerboating.

 2. I shall be liable to pay 75% of the total course fees if less than six weeks notice of cancellation is given.

 3. I shall forfeit all monies if two weeks or less notice of cancellation is given.

 4. Refunds due to my cancelling are in accordance with booking conditions (you may consider insurance cover worthwhile for this).

 5. The signing of this form signifies that:

I am confident in water

I am physically fit to take part in the activity

I am willing to comply with all safety regulations

 Lymington Town School of Sailing & Powerboating can accept no responsibility for vehicles parked at the Club.

 We reserve the right to cancel the course if the number of students has not reached the minimum requirement within four weeks of the course commencing.

 I have read and accept the booking conditions

 Course fee ___________

 Publications ____________

Total enclosed ______________

(please make cheques payable to LTSSP)


 Signature ___________________________Date _______________

 (If under 18 a Parent/Guardian must sign)

 ________________________________________________________

 OFFICE USE ONLY

 £_______________________ Receipt No. _____________________

 Date entered on course list and joining instructions sent ___________