Booking Form

Name:
Street Address:
Town/city:
Country/State:
Post Code:
Is your postal address the same as your street address? YesNo
Postal Address:
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Post Code:
Telephone Daytime:
Telephone Evening:
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E-mail:
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Please tick if you would like to receive weekly emails regarding courses, charters and specials: yes
Shoreside contact in case of
emergency:
Course Description :
Date from:
Date to:
Previous Sailing / Boating / Theory:
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Please tick if you have a voucher: Yes
Health: Do you suffer from epilepsy, diabetes, heart disease, asthma or similar ailment? Please specify :
Special Dietary requirements:
Date of birth (complete only if applying for RYA day Skipper or Coastal Skipper)
For our marketing purposes please indicate age:
  Yes I have read and understood the terms and conditions
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