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Please fill in the application form below. We will then contact you to request payment.

Alternatively you can download a PDF application form which can be printed out and faxed or posted back to us at:

Please note: The information given on this form will remain confidential, it is used to help staff meet your needs and where necessary provide support and adjustments to allow you to fully enjoy your time with us. Failure to disclose relevant details of your or your child's health may put you / your child in danger during the activity.

 

 

Trafford Water Sports Centre

Rifle Road, Sale, Cheshire, M33 2LX

Tel: 0161 962 0118

Fax: 0161 495 9023

 

Adobe PDF Reader can be downloaded by clicking the logo

 

Please Note: * Denotes a required field

Name: *
Age: *
Address: *
Postcode: *
E-Mail: *
Emergency Contact Name: *
Emergency Contact Telephone: *
Course attending: *
   
Please tick all that apply:
   
Yes No Yes No
Heart Problems   Asperger’s syndrome
Diabetes   Autism
Asthma   Dyslexia
Eczema   Dyspraxia
Epilepsy   Carebal palsy
Balance problems   ADHD/ADD
Fainting   Other learning or social needs
Back problems   Sensory impairments
Allergies   Any other condiions which we need to know about to protect your/your child’s safety
   
Please give additional information including any medication you may need while attending:
   

The signing of this form signifies that:
I am confident in the water
I am physically fit to take part in the activity
I am willing to comply with all safety regulations
I accept that watersports and adventure activities are hazardous by their nature
I am willing to accept the Terms and Conditions of booking

I declare that i have read and understood the above:

* Date: * eg. 01/01/11
   

Note: We are no longer accepting cheques. Payment can be made by Debit or Credit card or cash. Please do not send your credit card details via email, we will contact you for payment or you can download the PDF form below and once filled in fax or post to us.

Trafford Water Sports Centre reserves the right to cancel any course. A complete refund of course fees will be given or where possible an alternative course offered.