Hillary Outdoors Medical and Consent Form
Hillary Outdoors Education Centre - Tongariro
Which course would you like to book on? *
PARTICIPANT DETAILS
First and Last Names *
Your answer
Participant's Gender *
Age 14-18 years, *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Phone 1 *
Your answer
Address
Your answer
Email *
Your answer
Please tick the box if you do NOT want to receive information about other courses at Hillary Outdoors. At no time will we ever sell or provide your information to anyone else.
Are you completing the Gold Duke of Edinburgh Residential Award? *
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