VI Surf Sessions Sign Up Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date of birth
*
-
Day
-
Month
Year
Date
Gender
*
Male
Female
Non Binary
Other
Prefer not to say
Location of choice
*
Friday 15th August , Croyde
Friday 26th September, South Shields
Sunday 28th September, South Shields
Thursday 23rd October, The Wave, Bristol
Preferred Time
*
South Shields 1pm
South Shields 3pm
The Wave (2pm)
The Wave (6pm)
Flexible with timings
Are you registered under British Blind Sport already?
*
What is your level of vision? This will enable us to plan coaches and assistance for the day.
*
Submit
Should be Empty: