Emergency Contact Form - Dorset Marine Training

Emergency Contact Form for RYA Courses – Dorset Marine Training

Please complete this form or alternatively complete the printed form attached to your email and bring it with you on the day of your course.

Any queries please contact enquiries@dorsetmarinetraining.co.uk

Please ask for our Privacy Policy for information on how your information will be stored and used. Your form will be sent automatically to emergency@dorsetmarinetraining.co.uk and is not stored on this website.

Client's Name and Date of course *

Please enter name of person on course

Name of Emergency Contact (not on same course) *

Relationship (friend, partner, colleague etc) *

Tel Number *

If you are on medication, carrying any medication or have a medical issue which the Instructor may need to be aware of, please write details below: (If unsure please feel free to call us to discuss). Please note that this information is provided in case of emergency - it is your responsibility to ensure that the medical condition does not prevent you taking part and you should seek medical advice if unsure. *

If none please write 'none'.

Do you have a reasonable level of fitness required to participate in the course? *