Participation Form
Welcome, before your course or activity with Outdoor Matters we require you to complete this Participation Form. Please answer all of the questions in the form below.
Start date of your course
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Type of course
*
Climbing
Navigation
Hill & Moorland Leader
Lowland Leader
Other
Back
Next
Name
*
First Name
Last Name
Email Address
*
example@example.com
Date of birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Address
*
Line 1
Line 2
City
County
Postcode
Phone Number
Please enter a valid phone number.
Format: 00000000000.
Back
Next
Emergency contact name
*
First Name
Last Name
Emergency contact number
*
Please enter a valid phone number.
Format: 00000000000.
Do you have any medical conditions we should be aware of?
*
Are you currently taking any medication?
*
If yes, please give details.
Do you have any injuries that may impact on the day?
*
Back
Next
Time to sign
Before you sign this Participation Form, please read our Statement of Risk and our Terms and Conditions
“We recognise that climbing, walking and adventurous activities have a potential for personal injury.”The likelihood of you receiving minor cuts and bruising is high, whereas more serious injuries are less likely if you follow the instructions and advice given by the instructor.
*
I agree to the above Statement of Risk
As part of the course or activity day photos will be taken and shared with you online
*
I'm happy that photos will be taken on the course or activity.
No photos please
Our Terms and Conditions can be read at: https://outdoor-matters.co.uk/payment-and-terms/.
*
I agree to the Terms and Conditions
Please sign below to complete this form
*
Parent or Guardian (if under 18)
First Name
Last Name
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Submit
Should be Empty: