Booking Form

Full Name: email:

Preferred Name:

Date of Birth: Age at time of course:

Address:

Tel: Mob:

Previous Experience/Qualifications:

Any Medical Conditions:

How did you get to know about us?

Today’s Date: Preferred Course date:

Courses you wish to book: Price:

Please circle you choices below-

Craft to be used: your boat   or  PPT’s

Location: Pwllheli Other (for own-boat tuition only)

Credit/Debit Card Number:

Start date: Exp date:
Iss’ Number (Switch):

Name on Card:

Is the Billing address same as above? Yes or No  Total Amount: £