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Booking form: Private Course

Please contact us first to agree a date and course then fill in this form. All the information you share is held in strictest confidence

  Remember address information?
Course venue
Course date
Participant's firstname
Participant's surname
 
Date of birth (DD/MM/YYYY)
Parent/guardian (if <18 yrs)
Address line 1
Address line 2
Town/City
Country
Postcode
Mobile number
Landline number
Email (Guardian's if <18 yrs)
Repeat email
How did you hear about this course?
  Add to mailing list?
Any medical condition, allergies or special requirements?
Emergency contact/phone number
Amount to pay for your private course
(agreed with Wildwood)
Declarations
If you are under 18, your parent/legal guardian (named above) must agree to these declarations and submit this form to consent to your attendance. Older participants must agree themselves.
  I have read, understand, and agree to the Terms and Conditions.  I also declare that the information I have provided is correct and complete to the best of my knowledge.