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Booking form 2006
(Print out and send to Ocean Discovery at address below)

Course applied for ______________________Date of course_______________

Surname                      _____________ First Names________________________

Date of Birth              ____________________________________________
___

 
Address                      ____________________________________________
___
 

           Town               _______________________________________________

 

           County            _______________________________________________


           Post Code       _______________________________________________
 

           Country           _______________________________________________

Telephone No:          Home __________________ Work __________________   

email                           _______________________________________________   

Passport No.               _______________________________________________   

Occupation                 _______________________________________________

Next of Kin:     Name ______________________________________  

                        Address ______________________________________________

Telephone No.________________________________

Medical conditions      _______________________________________________

Allergies                     ________________________________________________

Dietary Requirements________________________________________________

Experience in Activity_________________________________________________

                                    _________________________________________________ 

Declaration I have read the terms and conditions and understand that I must have adequate travel and medical insurance.  I enclose my deposit (without which my booking will not be valid).

I am confident in the water, I am physically fit to take part in the activity and I am willing to comply with all safety regulations.

Signed                   ______________________________________

Date                      ______________________________________

Please return your completed form and deposit to: Ocean Discovery, Cefn Y Coed Uchaf, Llanfaglan, Caernarfon, Gwynedd, North Wales, LL54 5RF

email: info@oceandiscovery.net

Telephone No: (01286) 672773

Cheques to be made payable to Ocean Discovery Ltd.                                                          back to top