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Booking Form

Name *:
Street Address *:
Town/city *:
Country/State *:
Post Code *:
Is your postal address the same as your street address?	YesNo
Postal Address:
Town/city:
Country/State:
Post Code:
Telephone Daytime *:
Telephone Evening:
Mobile:
E-mail *:
Please confirm E-Mail *:
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:
Payment method *:
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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