Medical and Personal Information Form. Updated January 2026

Medical and Personal Information
Please submit this form to Peak Walking Adventures, prior to taking part in your guided walk or navigation day. Thank you.
Name

First NameLast Name
Your Email
example@example.com
Which organisation are you from (if appropriate to your walk)?
Organisation Name
Date of your Walk

MonthDayYear
Date
Which organisation are you from (if appropriate to your walk)?
Organisation Name
Address

Street Address

Street Address Line 2

CityCounty, Province or State & Country

Postal / Zip Code
Mobile Phone Number :
Emergency Contact - Please provide an emergency name and contact number for the duration of your activity.
Details of any existing injuries and / or medical conditions
I declare that I am fit to participate in the activity providedI accept the risks involved and am responsible for my own actions and/or involvementI am agreeable to the information on this form being securely retained for future use and will be given the opportunity to update it if requiredI agree to being contacted by e mail about the activities I have bookedI would like to be added to the Peak Walking Adventures E mail list for occasional newsletters
Repeat CustomerGoogle SearchFacebookInstagramLinkedIn'Visit Peak District' WebsiteWord of MouthOther
Please sign below (type your name)
Signature
Date
00/00/00
Please sign below ( type your name )
Date
00/00/00
Thank you for completing the above. Details of our privacy policy can be found here:

https://www.peakwalking.com/j/privacy
Should be Empty:

Medical and Personal Information