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Hillary Outdoors Consent Form
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Email
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Your email
Hillary Outdoors is a not-for-profit service that relies on a minimum number of participants to run each programme. Where the minimum number is not achieved, activities may need to be cancelled/amended or re-scheduled (subject to availability).
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I understand
Which course would you like to book on?
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7-Day Leadership Programme TONGARIRO, 5pm Saturday 6th July to 1pm Saturday 13th July 2024
5-Day Holiday Action Challenge TONGARIRO, 5pm Sunday 7th July to 1pm Friday 12th July 2024
7-Day Leadership Programme TONGARIRO, 5pm Saturday 14th December to 1pm Saturday 21st December 2024
5-Day Holiday Action Challenge TONGARIRO, 5pm Sunday 15th December to 1pm Friday 20th December 2024
Expression of Interest: January Holiday Action Challenge TONGARIRO
Expression of Interest: Duke of Edinburgh BRONZE Practice and Qualifying Adventurous Journey TONGARIRO
PARTICIPANT DETAILS
First and Last Names
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Your answer
Participant's Gender
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Female
Male
Transgender
Non-Binary
Prefer not to say
Ethnicity
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New Zealand European
Māori
Samoan
Cook Islands Māori
Tongan
Niuean
Chinese
Indian
Other:
Required
Age 14-18 years, on first day of course
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Phone
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Your answer
Address
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Your answer
Are you signing up with a friend? If you want to be in the same group as them, please write their full name here.
Your answer
Are you completing the Gold Duke of Edinburgh Residential Award? If you are unsure, please select 'No'.
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Yes
No
If you ticked yes to doing your Gold Duke of Edinburgh Residential Award, you cannot be in a group with anyone you know. Please write the full name of anyone you know who is attending this course.
Your answer
Please tick the box if you do NOT want to receive information about other courses at Hillary Outdoors. At no time will we ever sell or provide your information to anyone else.
I do not want to receive information about other courses
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