Attendee Form

    Participant Details (required)

    We are required to ensure every participant fills in these details for safe operation of our courses, events and membership.

    Next of Kin Details (required)

    Specify Your Course (required)



    Specify Your Event (required)

    Membership Details (required)


    Medical (required)

    Please answer the following questions.
    Be assured that answering ‘Yes’ will not necessarily prevent you from taking a full part.

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo


    Declarations

    YesNo

    YesNo


    By providing a Start and Finish Date, I understand that for the duration of the stated time this Information shall be used and understood by Provela to be correct. Should this information change within the dates stated I shall inform Provela as soon as possible. If I do not inform Provela of any changes I understand that they are not liable.

    I have read and agree to the Provela’s Terms and Conditions. I also consent to the above details being used to contact me. Read T&C's

    I declare that the responses I have provided above are correct to the best of my knowledge and I know no reason related to my health and well-being that will prevent me from undertaking this course. I will inform the Instructor immediately should I have any difficulties during the course.