Simon Winkley Marine: candidate information & fitness/medical declaration

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A few simple questions to get you booked in and to keep you safe during the session

First name *

Surname *

Preferred pronouns? This optional question helps to understand the best way way to address you

She/her

He/him

They/them

I prefer not to say

Other:

Clear selection

Mobile number *

email address (for invoicing and for the next question) *

Would you like to be added to Simon's email list for coaching availability and updates? *

Yes

Next of kin name *

Next of kin contact number *

Type of tuition *

Course

1:1 or 1:2 windsurf or wingfoil session

UK clinic

Overseas clinic

Location and date of tuition *

Participation in watersports requires a certain level of fitness and capability. Please state your readiness for participation in the activity *

I am able to participate

I have a fitness level, medical condition or situation that may need to be discussed before participating (please give details below)

If you stated above that you have a medical condition or situation please give details

Do you have any medication they you may need to access during the session (such as an inhaler or auto-injector)? *

Yes I carry medication (please give details below)

If you stated above that you may need to access medication during the session please give details

What is your level of water-confidence? *

High level of water confidence

Medium level of water confidence

Low level of water confidence

Privacy Policy
1) The data given on this form is subject to GDPR regulations. It will be used for the sole purpose of facilitating your place on the course/session. It will be kept securely and will only be shared appropriately in the event of an accident, illness or incident occurring during the course or in direct communication with the host centre or RYA or other stakeholder (where necessary) or to communicate the cancellation of any part of the course/session. It will neither be shared with a third party nor used for marketing purposes
2) On completion of a course: names, certificate numbers and date of issue will be stored for up to 3.5 years for successful candidates, before secure deletion. This information facilitates the verification or replacement of certificates if required
3) On completion of a session (lesson or clinic): names only will be stored - with all other information deleted securely
4) Data Protection Act 1998. The above information including the questions as to your health and ability will be used to process your booking for the course and for attending to your safety whilst you are on the course

Thank you for taking the time to complete the form.

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