Hillary Outdoors Medical and Consent Form
Waiting List for 16-21 December 2018 Holiday Action Challenge
PARTICIPANT DETAILS
First and Last Names *
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Participant's Gender *
Age (14-18 years) *
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Date of Birth *
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Phone 1 *
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Address
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Email *
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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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