Enrolment Form

Participant Name (required)

Preferred Name (if different)

Email (required)

Mobile Phone (required)

Any allergies or serious medical conditions which may impair your time with us? (allergic to Elastoplast, Nut allergy etc)

In the event of an emergency or should you require urgent medical care, who do we contact?

Emergency Contact Name (required)

Emergency Contact Phone (required)

Relationship to you