DOVER SEA SCHOOL - RYA Practical & Theory Training Course application form

DOVER SEA SCHOOL APPLICATION FORM
e-mail - mailto:michael.oram@btinternet.com
Telephone / Fax+44(0)1843 852858 -
The Principal is Michael Oram - His contact information is
12 Vale Square, Ramsgate, Kent. CT11 9BX. UK

Course required__________________________ -- Practical / Theory
Date/s required ___________________________
Name ___________________________ Date of birth __day__month___year
Address _________________________ Nationality ______________
________________________________ Passport No ____________
Post Code ___________ Tele/Fax_____________mobile _____________

Group members: (name & address)
1. ______________________________ Date of Birth __ day__ month___ year
____________________________________ Tel/Fax _____________
Post code _________ Counrty ____________ Passport No _________
2. ______________________________ Date of birth __ day__ month___ year
____________________________________ Tel/Fax _____________
Post code _________ Country ____________ Passport No _________
3. ______________________________ Date of Birth __ day__ month___ year
____________________________________ Tel/Fax _____________
Post code _________ Country ____________ Passport No _________

Payment
Single/Group leader. Course fee(_____days).	£______.____
Group members (_______) Course fee.	£______.____
Accommodation / books / etc.	£______.____
Extras	£______.____ £______.____
TOTAL -- less VAT	£______.____
VAT 17.5%	£______.____
TOTAL including VAT @ 17.5%	£_____.___
Deposit -- £100.00 + VAT = £117.50 per person	£______.____
Balance due	£_____.___
Balance Paid -- on (date ___/___/___/)	£______.____

CREDIT CARD PAYMENT - I wish to pay by
Barclaycard/Visa ~ Mastercard/Access - Switch - Delta.
Name on card _______________ Total amount £ _____:___
My card number is :________________ Expiry date ___:___
Signature ___________________ date: __ day__ month ___ year

Bookings can be made by e-mail - fax - post or telephone Tel/Fax +44 (0) 1843852858. - Mobile 07860812591
alternative e-mail address michael.oram@btinternet.com
Please post completed form to 12 Vale Square, Ramsgate, Kent CT11 9BX

DOVER SEA SCHOOL APPLICATION FORM Page 2

Please read the information on the web site before completing this booking contract
Your answers to these questions are for safety and do not affect you attending the course

I/We can swim 50 metres in light clothing

YES / NO

SPECIAL REQUIREMENTS - Is any member of the group suffering from

Epilepsy, Disability, Giddy Spells, Asthma, Diabetes, Angina, or Heart Conditions.	YES / NO
Or any special health considerations	YES / NO
Or needs for Special Medication	YES / NO
Or requires a special Diet (please specify)	YES / NO
Are there any special requests or details for our attentions?	YES / NO

ADDITIONAL NOTES_________________________________________________ _____________________________________________________________________ _____________________________________________________________________
_____________________________________________________________________

Emergency contacts ashore during the course:
Name: _________________ Tel no's. ___________
Name: _________________ Tel no's. ___________
Name: _________________ Tel no's. ___________

I/we are fit to participate in the course activities and I/We are willing to comply with all safety regulations and conditions of booking. I/we have read the terms and conditions attached. My/our signature on the booking form implies acceptance of these terms and conditions. The person so signing has the authority of the other persons included on this booking form to accept the terms and conditions and to make the booking on their behalf.
Signature/s _____________________________ Date _______

TERMS AND CONDITIONS -- All contact/enquiries/queries are to be made through the office or to the School Principal. If required they can be addressed directly to the School Principal - Michael Oram. The Principal is responsible for the overall safety and running of the school although he may delegate some responsibilities to the school instructors and staff. Alternative contact can be Angela Oram +44 (0) 1843 852858 or Lance Oram (mobile 07768837793
1. We reserve the right to modify or cancel any course at our discretion and we shall not be liable for any loss, damage, delay or inconvenience resulting there from. Any cancellation by us due to circumstances beyond our control will limit our liability to the return of the fees and /or deposits already paid to the school or their transfer to an alternative booking.
2. The school reserves the right to retain deposits and fees paid in the event of the clients cancellation at any time prior to the start of the course. Any refunds made will be at the discretion of the school after expenses are deducted.
INSURANCE The school craft are insured for accident & third party liability. No responsibility is accepted in any circumstances for the personal effects or the illness or delays of the clients / pupils. The clients / pupils agree to indemnify the school and its instructors and staff against any liability claim whatsoever.
Personal travel insurance and a P111 form are recommended. P111 health forms are avalible from your local post office and explain the national health agreements with other countries. They must be completed before departure.