Booking Form

Booking Form

This form is to be used to book a course and date as advertised on our website, social media platforms or via bespoke private course. Please use one form per person - for individual or family bookings where one single payment will be made (excluding any deposit due). Your place is confirmed and guaranteed when either the requested deposit or payment in full has been made. Details of this will be sent with your course confirmation, if not already paid.
Full Name

First NameLast Name Preferred Pronouns
COURSE DETAILS
Course Title
Course Start Date

DayMonthYear
Date
Is Accommodation Required ? (additional cost will be sent via invoice)
Arrival date

DayMonthYear
If accommodaion is required
Approx arrival time Minutes
How many nights required?
Arrival date will be night before course start date unless otherwise advised
Vehicle registration number
CUSTOMER DETAILS
Address

House Name / Street Address

Street Address Line 2

CityCounty / State / Province

Postal / Zip CodeCountry
Nationality
Phone number
Please include country code of outside UK
E-mail
example@sea.com
Date of Birth

DayMonthYear
Date
Special Dietary Requirements
Medical Conditions, Allergies, Disabilities
Please include all medical conditions and any considerations that may be relevant for your course. This should include any adjustments you require for your course.
Details of Emergency Contact

NameContact Telephone Number Relationship to you
E-mail of emergency contact
example@sea.com
Are you a current Paddle UK Home Nation member?
Membership Number
Required For all guests who are NOT British, Irish or Commonwealth citizens, please fill in the following section
Passport number*
Place of issue
Next destination
Address as next destination if known
*If a passport is not available, another document may be used that shows identity & nationality:
Document type
Document number
PAYMENT DETAILS

If a third party is paying your balance, please ensure The following fields are input correctly:
Invoicing Company Details

Invoicing Company name Purchase Order Number
Invoicing email address
example@example.com
Invoicing Address
example@example.com
Terms & Conditions
By completing this booking form I confirm I have read and understood the Terms and Conditions relating to this booking, especially those concerning cancellation.
Date

DayMonthYear
Date
By completing this booking form I confirm I have read and understood theTerms and Conditions relating to this booking, especially those concerning cancellation. I understand that bookings are accepted on the understanding that Eila Wilkinson Coaching Safety regulations and instructions are observed. I accept that Eila Wilkinson Coaching, is not under any liability whatsoever in respect of loss or damage to personal property, not caused by the negligence or default of Eila Wilkinson Coaching, its suppliers, its agents and employees whilst attending the course. Participation in adventurous activities entails some risk of injury. Eila Wilkinson Coaching coaches and staff are trained and appropriately qualified to run activity sessions and will at all times proceed in a manner to limit the risk of injury. However participants accept that accidents and injury may occur. These details will be kept for a period of not less than 12 months. The holding and use of personal information is regulated by the Data Protection Act 1998. For the purpose of the act, the course proprietor is the Data Controller.
Please verify that you are human
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Booking Form

COURSE DETAILS

PAYMENT DETAILS

Terms & Conditions