DOVER SEA SCHOOL - RYA Practical & Theory Training Course application form

DOVER SEA SCHOOL APPLICATION FORM
mailto:michael.oram@btinternet.com - dssoffice@btinternet.com
Telephone / Fax+44(0)1843 852858 - +44(0)1843 580185
The Principal is Michael Oram - Chief instructor is Lance Oram
Office: 12 Vale Square, Ramsgate, Kent. CT11 9BX. UK

Course required: _____________________________________ -- Practical / Theory
Date/s required: _____________________________ Number of people __________________

Name ____________________________ Date of birth _day__month___year
Address __________________________ Nationality _____________
_________________________________ Passport No ____________ Post Code ___________ Tele/Fax_____________mobile ____________

Group members: (name & address)
1. _______________________________ Date of Birth __ day__ month___ year
____________________________________ Tel/Fax ____________
Post code _________ Counrty ____________ Passport No ________
2. _______________________________ Date of birth __ day__ month___ year
____________________________________ Tel/Fax ____________
3. _______________________________ Date of Birth __ day__ month___year
____________________________________ Tel/Fax ____________
Post code _________ Country ____________ Passport No ________

Payment
Single/Group leader. Course fee(_____days).	£______.____
Group members (_______) Course fee.	£______.____
Accommodation / books / etc.	£______.____
Extras	£______.____ £______.____
TOTAL -- less VAT	£______.____
VAT 17.5%	£______.____
TOTAL including VAT @ 20%	£_____.___
Deposit -- per person	£______.____
Balance due	£_____.___
Balance Paid -- on (date ___/___/___/)	£______.____

CREDIT CARD PAYMENT -
You can use Bank transfer - Barclaycard/Visa ~ Mastercard/Access - cash
Please supply your card details seperately by telephone - fax or post. We need your card number - expiry date - security number - name -and you post code.

Bookings can be made by e-mail - fax - post or phone Tel/Fax +44 (0)1843 852858. & +44 (0)1843 580185

DOVER SEA SCHOOL APPLICATION FORM - Page 2

Please read the information on the web site before completing this booking contract
Your answers to these questions are for safety and do not affect you attending the course

I/We can swim 50 metres in light clothing

YES / NO

SPECIAL REQUIREMENTS - Is any member of the group suffering from

Epilepsy, Disability, Giddy Spells, Asthma, Diabetes, Angina, or Heart Conditions.	YES / NO
Or any special health considerations	YES / NO
Or needs for Special Medication	YES / NO
Or requires a special Diet (please specify)	YES / NO
Are there any special requests or details for our attentions?	YES / NO

ADDITIONAL NOTES_________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Emergency contacts ashore during the course:
Name: _________________ Relationship __________________ Tel no's. ___________
Name: _________________ Relationship __________________ Tel no's. ___________
Name: _________________ Relationship __________________ Tel no's. ___________ Name: _________________ Relationship __________________ Tel no's. ___________

I/we are fit to participate in the course activities and I/We are willing to comply with all safety regulations and conditions of booking. I/we have read the terms and conditions attached. My/our signature implies acceptance of these terms and conditions. The person so signing has the authority of the other persons included on this booking form to accept the terms and conditions and to make the booking on their behalf.
Signature/s __________________Name ____________________ Date ___________

TERMS AND CONDITIONS -- All contact/enquiries/queries are to be made through the DSS officel. If required they can be addressed directly to the School Principal - Michael Oram. The Principal is responsible for the overall safety and running of the school although he may delegate some responsibilities to the school instructors and staff. Alternative contact can be Angela Oram +44 (0) 1843 852858 or Tanya Harding +44 (0)1843 580185 or Lance Oram, Chief instructor on (mobile 07768837793)
1. We reserve the right to modify or cancel any course at our discretion and we shall not be liable for any loss, damage, delay or inconvenience resulting there from. Any cancellation by us due to circumstances beyond our control will limit our liability to the return of the fees and /or deposits already paid to the school or their transfer to an alternative booking.
2. The school reserves the right to retain deposits and fees paid in the event of the clients cancellation at any time prior to the start of the course.
INSURANCE The school craft are insured for accident & third party liability. No responsibility is accepted in any circumstances for the personal effects or the illness medical conditions or delays of the clients / pupils. The clients / pupils agree to indemnify the school and its instructors and staff against any liability claim whatsoever.
Personal travel insurance and a European Health card are recommended. EHIC can be applied for online at www.dh.gov.uk/travellers the web site explains the national health agreements with other countries. They must be completed before departure.