Booking Form 2003logo.gif (33298 bytes) 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 full course fee. 
One form is required per person per course.
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 _______   
(Cruising courses run 10am Monday to lunch time Friday - unless otherwise stated or planned)

Course Fee € __________
   
Clothing Rental Coastal Waterproofs Jacket & Salopettes (cruising) €6 per day or  €3 for 1 piece (adults only) € __________
Sleeping Bag Rental Laundered Sleeping Bag €20 per bag for full duration of course € __________
Other 2   € __________
Total Due € __________

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 € ________
___ I would like to make a bank transfer (go to http://www.westcorksailing.com/bookingdetails.htm)
I have read the booking conditions and agree to them.
Signed by course attendee __________________or Signed by Parent if attendee under 18  _________________

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