Booking Form

Course Name

Course Start Date (YYYY-MM-DD)

Name

Date of Birth (YYYY-MM-DD)

House Name / Number

Street

Town

Post Code

Mobile Number

Email Address

Next of Kin

Next of kin relationship to you

Next of kin home contact number

Next of kin mobile number

Please list any allergies you may have (food, drugs, animals, etc.) If none please enter N/A

Have you had or are having any medical treatment that maybe compromised by your taking part on the booked course?Please answer Yes or No – If Yes please give details

Are you currently suffering from an injury or condition, which may affect your full participation on the course ?Please answer Yes or No – If Yes please give details

Please enter today's dateBy entering the current date and submitting your form, you confirm that the information you have provided is correct to the best of your knowledge. All personal data is kept securely and held in the strictest confidence. Many thanks (YYYY-MM-DD)

The BMC Participant StatementThe British Mountaineering Council recognises that climbing, hill walking and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions. Rock Climbing and Mountaineering are physically demanding. The days will be tailored as much as possible to suit your technical abilities and physical capabilities, however for your own safety, we reserve the right to stop you participating at any point, for whatever reason. The mountain and cliff environments are subjected to unpredictable and highly active forces of nature, conditions can change at any time. For safety reasons activities may have to be modified or cancelled at very short notice. This decision may be made at any point during the course, but when at all possible, an alternative will be offered. In signing this form you are accepting that there is risk of accidents and injury in the activities you will be undertaking. Please enter your name below to confirm your acceptance.

Photo and media consentDuring your course we will take photos and videos to capture your time with us and for coaching purposes. We also like to use photos / videos from our courses on our publications, promotional materials, websites, social media platforms, DVDs and other marketing materials. Please indicate below whether or not you give consent for us to use your images / videos on our promotional material, website and social media platforms.

Choose one option

YES

Booking Form

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