Compulsory boxes are marked with*

First Name *
 		Surname *
 		Date of Birth
 		  
 
Address
 		City
 		Post code/Zip code
 
Country/Region
 		Home Phone #
 		Mobile #
 
Email Address *
 

Course or Expedition Name*

Date Selection *
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Secondary Date Selection (leave blank if only one option)

What equipment will you require?  
All 
None

Kayak
Paddle
Spray Deck
Helmet
B-aid
Wetsuit
Jacket

Equipment size

Do you have any medical conditions we need to be aware of?

How would you describe your swimming ability?

What is your current kayaking experience?

Emergency Contact Information (include home & mobile # if applicable)

Groups (2 or more individuals)
Please fill out a registration form for each individual in your group
Group Leaders paying for others, please list those members
Here to help us keep your group together.

How would you like to make your payment?  By Post     Online Payment

We will send you the link to the payment page via email, if you select online payment above.

How did you hear about Sea Kayaking Cornwall? 
Recommendation Magazine Article Web Search
Brochure  NEC     Symposium Other

Please note that a 20% deposit is required on booking to reserve your place.  Full payment must be received 8 weeks before the start of the course.  If booking on a course that is to commence within the next 8 weeks please pay in full on booking.

Cheque Payable to Sea kayaking Cornwall sent to;

Sea Kayaking Cornwall
78 Pengarth Rise, Falmouth, Cornwall, TR11 2RR

Questions or Comments

* Please note that your selection is NOT confirmed until we have received your deposit and confirmed your reservation via email.

   

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