Super Kite Day Kitesurfing School JEDDAH KSA
MEDICAL FORM 2018
Email address *
Please fill this form and sent it back to us via superkiteday@gmail.com
Name *
Date of Birth *
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Email *
Phone number *
Address *
How did you find out about Super Kite Day? *
Physical state
Note: Whilst participating you will be taking part in 'Adventurous Activities' which involve some personal risk. It is a legal requirement that before starting any activity you fully complete the following medical declaration. The information will help us to keep you safe and structure an effective training program for you. Failure to declare full information will result in the termination of your course without refund.
Height (cm) *
Weight (kg) *
Can you swim 50m? *
Would you consider yourself water confident? *
Do you do any sports or previous kiteboarding experience?
I am:
My eyesight is:
Are you currently taking any medication? *
Do you suffer from any medical conditions or injury's that we need to be aware of whilst undertaking this activity such as Asthma, Diabetes, joint surgery etc.? *
Would you describe yourself as *
Next of Kin (Emergency Contact)
Name *
Phone number *
Relation (Family/Friend)
Declaration
I declare that the information given above is accurate and true, and that I have not knowingly withheld any information. I understand that to knowingly withhold information could result in the termination of my training without refund.
Sign (Insert full name below as record of digital online signature) *
Date *
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Thank for for completing the Super Kite Day Kitesurf School Medical form
What to do next:

We will arrange by email or whats app for payment and an invoice receipt. We will also arrange the meeting time for your course. Contact +966 507 977 603 superkiteday@gmail.com
We look forward to seeing you on the beach.

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