Booking Form

Student's First Name *

Student's Surname *

Name known by if different

Student's home telephone number *

Student's mobile telephone number*

Emergency contact number *

Student's email address *

Confirm student's email address *

Student's date of birth *

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Student's Gender *

Student's Address Line 1 *

Student's Address Line 2

Student's City *

Student's Postal Code *

What is your reason for attending? *
(tick all which apply)

Off to University
Life Skills
Chalet Host
D of E Gold Residential
Queens Scout/Guide
St John Grand Prior Award
International Baccalaureate
Other

Other

Name of School/College

Name of Award Leader

Email of Award leader (if known)

As we often run two venues, please let us know if you will you be attending with a friend.

Yes       No

If yes, what is their name?

Please use this space to tell us about anything you feel we may need to know to ensure your comfort and safety, such as allergies, dietary requirements for religious or medical reasons, medical conditions, dyslexia, etc.

None(This information will be treated as confidential)

How did you find out about us?

Please confirm that you have read and agree to the Terms and Conditions *

Yes       No