Booking Form

Thank you for making a booking with Canoe Coaching. You may complete and email using the submit button, or print and post the form to the address above. A deposit or order number is required to reserve a place on the course. Confirmation of your place on the course will be sent by email or post.

With Thanks Tom Sibbald, Canoe Coaching.

Return to the Canoe Coaching home page

Canoe Coaching
22 Bannerigg
Oak Street
Windermere
Cumbria
LA23 1EP
United Kingdom
Tel: 015394 69002
mobile: 07962 059 251

Booking Form

Name and Contact details

Please fill in all fields marked with **

Name:** Email** Home telephone: Mobile: Address:

Please provide a contact name and telephone number for us to contact in the event of an emergency.

Emergency contact name: Emergency contact tel:

Course details

Please fill in all fields marked with **

Course Title** Date of course** Deposit:

Booking confirmation will be sent on receipt of either:

deposit Invoice order number Invoice number if known:

Please write down any relevent Medical issues:

PLEASE CHECK THE BOX IF YOU ACCEPT THE FOLLOWING DECLARATION
I declare that I am medically fit to undertake adventurous activities and I understand and accept that there is risk in the outdoor environment.

Special notes

Courses have varying requirements please complete the boxes below where appropriate

Please write down any special dietary requirements:

Please tick the radio button if you require audio visual eqipment for the BCU assessment lecturettes

Audio/Visual is required

Please write down any equipment you may wish to hire (on some courses there is a charge)

Any other comments: