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07803 351 390

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07803 351 390


Please fill out the enrolment form below.

About You

Contact Information

Check this option and complete to provide a different person's information for use during the expedition, in case of an emergency.

Medical Information

Does your son/daughter/ward have any medical conditions that staff should be aware of? Asthma, Diabetes, Epilepsy (or fits), Allergies such as Nuts, medication, plasters, aspirin/paracetamol, dairy products, fabrics, feathers etc.

Does the participant take any medication? Please provide details.

Can you please tell us approximately when was the last time your son/daughter/ward had a tetanus injection?

Other Information

Are there any activites your son/daughter/ward should not take part in due to phobias, culutural, medical or other religious reasons?

Does your son/daughter/ward have any special dietry requirements?

Please tell us about any mental health concerns, no matter how small they may seem.

Do you give permission for photos and videos of your son/daughter/ward to appear in promotional material for Ben Bullen Adventures (Website, Facebook, YouTube and leaflets)?

Parental/Guardian Consent