Paddlesports taster session

Paddlesports taster session

@ Edge Adaptive Sports Centre
FOR ADULTS WITH A PHYSICAL DISABILITY

These are coached camps encouraging progression. Feel free to bring an able-bodied friend/ partner!

Various dates in 2024. We will be in touch re options.

Equipment set-up, followed by approx. 1 hour paddling time with coaching
Full name*

First NameLast Name
Email*
Phone number*
Address (optional)

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:

Min £10, max £20.

Includes equipment, 1-hour paddling session on the main lake with coaching.
Please tell us what your primary disability is*
Is your disability acquired or congenital?*

AcquiredCongenital
If acquired, how many years since your accident/ injury?
If spinal cord injury, please provide more info
Level of SCI
If spinal cord injury, please provide more info

CompleteIncomplete
If other disability, please provide more info
Mobility*

WalkerWalker with aidManual wheelchair userPowerchair user
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
Approx. height*
Approx. weight (although there is not an official weight limit, we might contact you if we have concerns)*
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
Transfer skills *

1

2

3

4

5

1 is Worst, 5 is Best
Do you have a PA at home for personal care needs?*

YesNo
Do you suffer from asthma*

YesNo
Do you suffer from epilepsy*

YesNo
Can you swim or float independently in deep water?*

YesNo
Please tell us anything else we should be aware of
Would you like to bring an able-bodied partner/ friend to take part in the paddlesports session with you?*

YesNo
I hereby certify that the information given is correct to the best of my knowledge. Paddlesports can be dangerous. By signing digitally below, I assume any risk of harm or injury which might occur to the participant due to participation in the event or activity. I release Access Adventures from all liability, costs and damages which might arise from participation in the activity.
Signature

Clear
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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