Participant Name *

First

Last

Name of parent/gaurdian giving consent and filling in this form.

First

Last

Required if participant is below 18 years old.

Adventure Booked (please include the name and date of Your Adventure) *

Email *

Date of Birth (Day/Month/Year) *

Contact Phone Number *

Address and Postcode *

Medical Declaration *

Medical declaration 2 *

Medical Declaration 3 *

I am aware that, if I am in any doubt, I should consult my doctor about my physical suitableness for the booked activity

Listed Medical Conditions and Medication *

Emergency Contact Name *

First

Last

Relationship to participant *

Emergency Contact Phone Number *

Risk Acknowledgement *

"I recognise that climbing, hill walking, mountaineering and paddlesports are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement" I have read, understand and accept this statement and realise that whilst every effort will be made to maximise safety all outdoor activities carry risk.

Agreement *

All information supplied on this form is true and accurate at time of writing and if anything changes I will inform the instructor/guide before the activity begins

Terms and Condtions *

I have read, understood and agree to the Terms and Conditions found on the website (link below)
I understand it is my responsibility to seek appropriate cancellation insurance for the booked event(s)

How did you hear about us?

Please tick to consent to:

I consent to photographs taken of me during the activity being used for marketing purposes by Your Adventure Scotland
I consent to being contacted by Your Adventure Scotland about further products and services (no third parties)