Please select from the drop down below:
Name *
Date of Birth
Date of Birth
Health Issues *
Do you suffer, or have you ever suffered from:
Have you received a tetanus injection in the last five years?
Do you have any special needs or conditions about which the course leader should be aware?
Please add your emergency contact name and phone number below
By signing this form you agree to the following: I am aware that I will be involved in woodland activities to which I give my consent. I understand that activities due to their intrinsic nature present elements of risk but Woodland Learning Ltd staff will ensure these risks are kept to a minimum. I give my consent to have photographs and videos taken, and I understand that these may be used for promotional purposes. I understand that should medical treatment be necessary every effort will be made to obtain my consent or that of my emergency contact above. However in an emergency I authorise the course leaders to consent on my behalf to any medical treatment deemed necessary by a qualified healthcare professional (this may include inoculations, blood transfusions, surgery or the use of anaesthetics).
The OCNWM has requested information regarding ethnic background and employment for the purposes of programme registration and certification and compiling equal opportunities statistics. It is not compulsory to provide this information:
Employment status