Booking Form 2008

The Boathouse, Adrigole, Beara, Co Cork, Ireland Tel 027 60132 Fax 027 60247 Email info@westcorksailing.com www.westcorksailing.com

OFFICE USE ONLY BD    BK    C    1 rcvd €________ ___ date_____    2 rcvd €________ ___ date_____ 3 rcvd €________ ___ date_____

To reserve a course please print this form & post or fax your completed form with a booking deposit of €100 per
person / per course.  One form is required per person per course. We cannot accept credit card numbers on email.
First Name _____________________  Surname_________________________  Male ___Female___
Address _________________________________________________________________________
_________________________________________________________ Height ______ Weight_____
Email ____________________________________________ Age_____     Date of Birth ___/___/___
Can you swim? Yes __ No __  Personal Fitness Very Fit __  Reasonably Fit __ Not Very Fit __ Unfit__ 
Tel Home ____________________ Tel Work __________________ Mobile____________________
Where did you hear of us? ________________ Why did you choose us? ________________________
Any food allergies or preferences?______________________________________________________
Health Problems ________________________Are you on any Medication ?_____________________
Relevant Experience ____________________Relevant Qualifications___________________________
Course Details  Course Name___________________________________
Course Code _________  No Days ____    Course Only ___ or Go Inclusive ___ (please mark x)
Course Dates From _______ To _______    Accommodation Dates      Arrive ______ Depart ______
Go Inclusive customers arrive from 5pm evening prior to course start date & check out 9am on last day of course.

Payment Details  We cannot accept payment over the internet, but you can print this and post of fax it.
Please find enclosed a cheque cash draft for € ________
Please charge € __________ to Credit Card no. _________________________  Expiry Date ___ / ___
Cardholder Name _____________________  Type of Card Visa / Access / Mastercard / Eurocard
I have read the booking conditions and agree to them.
Signed by course attendee __________________or Signed by Parent if attendee under 18  _________________