This form can be printed and sent to the address at the bottom of the page. Alternatively, copy and paste the form into an email, enter your details and email to the address below.
Full Name: | |||
Address:
Postcode: |
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Tel. Daytime: | Tel. Evening: | ||
Date of Birth: | Nationality: | Email: | |
Course Title: | Dates: | ||
Sailing Experience & Qualifications: | |||
Next of Kin (Person we should contact if you have a serious accident or illness): | Please give details of any relevant medical conditions or treatments. If none, write “none”. | ||
The terms & conditions below will be included in every contract between you the student and the Crouch Sailing School. By signing the booking form you will be accepting the terms & conditions as set out below and on our Terms & Conditions page.
NB. you may wish to make a copy of this booking form for your own files. |
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50% Booking deposit £……………. The balance of £………………. is due by ………………….. Note that payment is by cheque or bank transfer only. We do not accept cards or cash. |
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Cheques payable to Desmond F Purcell YM and returned to (POSTAL ADDRESS ONLY):
44 Petticrow Quays, Belvedere Rd, Burnham on Crouch CM0 8JA Tel: 07557 474160 |
Or payment by bank transfer to Desmond F Purcell YM:
Account number: 04013931 |
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I declare that I am fit to participate in this course. Signed |
Date |