Adult NICAS Course November 2024

4 Week Adult NICAS Course 19th November 2024 Registration
Course Dates*

Tuesday 19th November- Tuesday 10th December 2024
How many adults do you wish to book?*

1234
Adult 1 Details
First Name *
Surname *
Age*
Age when attending course
Health Information

All fields are required below. If nothing applies, please put "NONE" in the box.
List any past medical treatment that would be helpful for us to know.
Adult 2 Details
First Name *
Surname *
Adult Age*
Age when attending course
Health Information

All fields are required below. If nothing applies, please put "NONE" in the box.
List any past medical treatment that would be helpful for us to know.
Adult 3 Details
First Name *
Surname *
Adult Age*
Age when attending course
Health Information

All fields are required below. If nothing applies, please put "NONE" in the box.
List any past medical treatment that would be helpful for us to know.
Adult 4 Details
First Name *
Surname *
Adult Age *
Health Information

All fields are required below. If nothing applies, please put "NONE" in the box.
List any past medical treatment that would be helpful for us to know.
Please review before moving to Parent & Payment details

My Products*

NICAS Adult Member/UCC Staff/UCC Student RateMember/UCC Staff/UCC Student Rate

€60.00 Quantity
Item subtotal:€0.00

NICAS Adult Non-Member Rate

€70.00 Quantity

Total

€0.00

Please ensure all information is correct before submitting.

Ensure payment options align with booking details. Please note course requires a minimum of 6 participants.
Should be Empty:

Adult 1 Details