2022 BOOKING Form - GreenWise People CPD Days / Wild Workshops for Adults
I am aware that I will be involved in woodland activities to which I give my consent. These will include the use of fire, tools and cooking. I understand that activities in a woodland setting, due to their intrinsic nature, present elements of risk - the GreenWise People team will ensure that these are kept to a minimum.
Sign in to Google to save your progress. Learn more
Email *
What days will you attend?
Full Name *
Home Address
Contact Details (mobile/work) *
Email address *
Date of Birth *
MEDICAL INFORMATION
Doctor's name, address & phone number *
I understand that should medical treatment be necessary, every effort will be made to obtain my consent. However, in an emergency I authorise the party leaders to consent on my behalf to any medical treatment, which a qualified doctor feels is necessary (this could include inoculations, blood transfusions, surgery or the use of anaesthetics). *
I have included below full details of any recent illness or medical condition of which the party leader should be aware, including details of medication or special diet *
Required
Do you suffer from or have you ever suffered from: *
YES
NO
Heart Condition
Diabetes
Epilepsy
Ashtma and Bronchitis
Eczema
Ever been stung by a bee or wasp?
Sight or Hearing difficulties
Any other allergies, please give details below
If you answered YES above or any other pertinent medical information, please give details below
Please give details of any regular medication, reactions to stings, learning or educational needs etc.
Dietary considerations
Next of Kin Emergency Contact (name, telephone number & relationship) *
Photo permission - I give my consent to have photographs taken & understand that some of these may be used for promotional purposes *
I understand that in order to secure my place at the CPD workshops listed, payment in full has to be received in advance.  
*Workshops will only be cancelled in extreme weather conditions such as thunder and lightning as well as winds of over 40 knots.                                                        **In the event that the facilitators are unable to deliver, a full refund or alternate date will be provided.   ***Should the client be unable to attend due to any extenuating circumstances, the payments are non-refundable, however they can be transferred to an alternate course which is to be attended within 12 months of the date of the given course.
 *
Required
How did you hear about the workshops? *
Signature *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms