Southampton, UK    +44 (0)7 515 486 789           Info@SouthCoastSailing.co.uk  
Solent-based sail instruction, cruising and charter on a quality, performance yacht
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Booking Form

[ PDF/Printable Version ]

We are unable to confirm any booking until we have received a fully completed booking form for each student. It is important for your own safety that you make a full and accurate decaration; this form can not be submitted unless fully completed. Please write 'none' in any sections that do not apply. Your data will be held by South Coast Sailing for administration purposes and your own safety. It will not be shared with any other organisation without your permission. This form has been designed to be submitted on-line. If you are unable to use it sucessfully please use the printable version instead.

Please complete ALL fields. Write 'none' in any sections that don't apply.

  Your sailing course
Course Name      If 'Other':
Course Dates
 
  Your personal details
Firstname Lastname Known as
Date of Birth (DD/MM/YY) Sex  
//  
 
Address
 
Town    County  Postcode 
Phone   Mobile  E-mail 
 
  Shore Contact - Please name someone we can contact if necessary while you're aboard
Name Phone(s) Relationship
Address
 
  Your sailing background
RYA Qualifications
Sailing experience
 
  Your requirements
Waterproofs Size (M=Male / F=Female)    
Any special diet
Other
 
  Your health - Please make a full declaration for your own safety. If none please write 'none'
Please list ALL current medical conditions and/or restrictions to full mobility/health/fitness.
Please list ALL current medication.
Can you swim 100 metres?  Weight(kg)  Height(m)
 
  Your declarations

The above information is complete and accurate and I have read
and agree to South Coast Sailing's Terms and Conditions.

Data Protection Act 1998: I understand that the above information will be used by South Coast Sailing to process my booking and to attend to my safety whilst I am on the relevant course(s) and that my data may be shared with the RYA.

     I agree
*
 
 
Anti-spam code *                              Please re-type the code here:          

Send a copy of this form to my e-mail address (given above)

Submit this booking form now      
 
Bookings can only be confirmed after a booking form is accepted and the required payment is received.  
 
 
 
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