Waterski & wake camp application

Waterski & wake camp

@ Edge Adaptive Sports Centre, Staines
FOR ADULTS WITH A PHYSICAL DISABILITY

THESE ARE COACHED CAMPS ENCOURAGING PROGRESSION

Arrive Fri evening, skiing on Sat & Sun

Access Adventures aims to be as inclusive as possible, but there are some limitations for each activity to ensure safety. Contact us with any concerns.
Name*

First NameLast Name
Email*
example@example.com
Phone number*
Address

Street Address

Street Address Line 2

CityCounty

Postcode
D.O.B.*

DayMonthYear
Date
Gender*

MaleFemale
We ask for a donation towards the cost of this camp:

£150 (subsidised) - £250 (actual cost)

Includes 2 nights accommodation, full catering, equipment hire & instruction, plus a minimum of 4 coached waterski/ wakeboard sessions.

Accommodation is hostel-style - shared rooms (max 3 per room), shared bathrooms.

We cannot accommodate specific room requests as we have to consider the group as a whole. Thanks for your understanding.
Please tell us what your primary disability is*
Is your disability acquired or congenital?*

AcquiredCongenital
If acquired, how many years is it since the accident/ onset?
If spinal cord injury, please provide further info
Level of SCI
If spinal cord injury, please provide further info

CompleteIncomplete
If other disability, please provide any further info
Do you have a cognitive impairment? (this can mean when a person has trouble remembering, learning new things, concentrating, communicating, or making decisions that affect their everyday life)*

YesNo
Please describe any cognitive impairment
Please tell us of anything else we should be aware of
Mobility:*

WalkerWalker with aidManual wheelchair userPowerchair user
Do you have a PA at home for personal care needs?*

YesNo
We will cover accommodation & catering costs for essential PAs. Please contact us with any concerns.

These weekend camps are just for adaptive skiers, we do have other opportunities where you can bring an able-bodied friend, email us for options.
Level of fitness*

1

2

3

4

5

1 is Worst, 5 is Best
Balance*

1

2

3

4

5

1 is Worst, 5 is Best
Upper body strength*

1

2

3

4

5

1 is Worst, 5 is Best
Grip*

1

2

3

4

5

1 is Worst, 5 is Best
Weight (we might contact you if we have concerns about available equipment or instructor abilities)*
Height*
Which date(s) would you like to apply for?*

June 27 - 29 (for intermediate & advanced skiers/ riders)July 11 - 13Aug 8 - 10Sept 5 - 7
If applying for more than one camp, please select your 1st choice

June 27 - 29 (for intermediate & advanced skiers/ riders)July 11 - 13Aug 8 - 10Sept 5 - 7
Where did you hear about us?*
We would like to contact you with information about our services. This may include details on camps, volunteer opportunities, how you can donate, fundraising events. We won't share your information with others without your permission, except in an emergency. Your data will be used and stored in accordance with the 'General Data Protection Regulation 2018' Please refer to our website for our full privacy policy
Please DO contact me by (mark ALL methods you would be happy with)*

EmailPhonePost
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