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BOOK A COURSE
BOOKING FORM DREAM BIG KITESURFING SCHOOL TODAY’S DATE__________________ FIRST NAME____________________ SURNAME_______________________ HOUSE NUMBER & STREET NAME TOWN AND PROVINCE _________________________________ _________________________________ HOME PHONE NUMBER CELL PHONE NUMBER ___________ _______________________ _________________________ AGE OCCUPATION COURSE DATE/S ___________ _______________________ FROM_________TO_______ EMAIL ADDRESS PLEASE TICK REQUIRED COURSE - KITESURFING TASTER DAY R 999.00- 2 DAY BEGINNERS COURSE R 1999.00- BEGINNER ONE TO ONE COACHING R 399.00 PER HOUR(MINIMUM 8HOURS) - INTERMEDIATE ONE TO ONE COACHING R 299.00 PERHOUR(MINIMUM 4 HOURS) BOOKING CONDITIONS - ALL STUDENTS MUST BE OVER 18 YEARS OF AGE OR ACCOMPANIED AT ALL TIMESBY A PARENT OR GUARDIAN - ALL COURSES ARE BOOKED FOR THE SPECIFIED DATES ABOVE AND ARE NONTRANSFERABLE- YOUR LESSON STARTS AT THE PRE ARRANGED TIME PROMPTLY AND IF YOU ARELATE FOR YOUR LESSON YOU WILL STILL BE CHARGED THE FULL RATE - CANCELLATIONS WITH LESS THAN 7 DAYS NOTICE WILL BE LIABLE FOR FULLPAYMENT - FULL PAYMENT MUST BE MADE AND RETURNED TO US WITH THIS FORM 7 DAYSPRIOR TO THE COURSE DATE STARTING - IN THE EVENT OF A COURSE BEING UNFINISHED DUE TO ADVERSE WEATHER ORSTOPPED FOR ANY OTHER REASON BY THE INSTRUCTOR, YOU WILL BE OFFERED TWO FIXED DATES ON WHICH TO RETURN AND COMPLETE YOUR TRAINING. FAILURE TO ATTEND ON THE DATES OFFERED, WILL RENDER ANY OWED TIME VOID - THE INSTRUCTORS DECISION IS FINAL- ALL KITE AND SAFETY EQUIPMENT WILL BE PROVIDED BY US.- ALL EQUIPMENT IS STANDARD SIZES, SMALL, MEDIUM ETC- ALL OUR INSTRUCTORS ARE FULLY TRAINED AND INSURED- STUDENTS MUST BE AWARE THAT POWER KITE SPORTS ARE POTENTIALLYDANGEROUS AND ARE UNDERTAKEN AT YOUR OWN RISK ALL STUDENTS MUST SIGN IN AGREEMENT WITH THE BOOKING CONDITIONS AND MAKE FULL PAYMENT 7 DAYS BEFORE THE COMMENCEMENT OF THE COURSE THE LEVEL YOU REACH IS DETERMINED BY YOUR INDIVIDUAL ABILITY & AS SUCH CANNOT BE GUARANTEED SIGNED BY THE STUDENT___________________________________ PLEASE COMPLETE MEDICAL QUESTIONS OVERLEAF DREAM BIG KITESURFING SCHOOL ESSENTIAL MEDICAL INFORMATION SECTION A. PERSONAL DETAILS HEIGHT________________ WEIGHT_____________________ WOULD YOU DESCRIBE YOURSELF AS – VERY FIT___FIT___UNFIT___VERY UNFIT___WOULD YOU DESCRIBE YOURSELF AS- VERY GOOD SWIMMER___WATER CONFIDENT___ POOR SWIMMER ARE YOU A – SMOKER___NON SMOKER___SECTION B. NEXT OF KIN (WHO SHOULD WE CONTACT IN CASE OF EMERGENCY)NAME__________________________________ CONTACT NUMBER________________________________ RELATIONSHIP (IE SPOUSE)____________________________________________________________ SECTION C. DOCTOR NAME OF DOCTOR______________________ PHONE NUMBER__________________________________ ADDRESS_____________________________________________________ SERCTION D. YOUR CURRENT HEALTH HAVE YOU BEEN PRESCRIBED ANY MEDICATION WITHIN THE LAST THREE MONTHS OR ARE YOU CURRENTLY TAKING ANY MEDICATION YES______ NO_____ IF YES, GIVE DETAILS______________________________________________________ DO YOU SUFFER/HAVE PROBLEMS WITH ANY OF THE FOLLOWING HEARING___SIGHT___MUSCLES & BONES___ALLERGIES___LEARNING DIFFICULTIES___ DIABETES___ HEART___ IF YES, GIVE DETAILS______________________________________________________ ARE THERE ANY MEDICAL FACTS THAT YOU HAVE NOT INCLUDED ON THE FORM BUT WOULD PREFER TO DISCUSS WITH A SENIOR MEMBER OF STAFF YES_____NO_____ SIGNED BY STUDENT INTERNAL USE ONLY CHECKED BY - FIRST NAME___________________________SURNAME______________________ SIGNED BY INSTRUCTOR__________________________INSTRUCTOR ID NUMBER___________ RISK ASSESSMENT REQUIRED – YES_____NO_____ | ||||