Client safety information Gathering information in advance of the day on the waterPlease enable JavaScript in your browser to complete this form.Your Full Name *Email *Mobile phone number *Date of birth *Town where you live (or nearest one)? *Emergency contact name *Emergency contact numberIf you are hiring kayak/kit please tell me your approx height and weightPlease list any relevant medical issues that may affect your time on the water (copy) *If none please write noneIf you carry any medicine, where do you keep it? *If none please write noneAre you happy for your mobile number to be included in a WhatsApp group for ease of information sharing related to this trip? *Yes I am happy with thisNo thanks prefer email / I don't use whatsappPrivacy: Are you happy for photos, videos taken on the trip in which you appear to be used within promotional material on paper and online including social media. *Yes I am happy with thisNo thanksDISCLAIMER Sea kayaking and its associated activities, carries risk of injury and in very rare cases, death. I declare, I am fit and healthy, to the best of my knowledge to take part in sea kayaking activities, and I have declared above any relevant medical information. *Please read and add your initials to the box Are you happy to receive occasional marketing email from me? *Yes I am happy with thisNo thanks.NameSubmit
