Holiday Booking - WISE UP Workshops CIC

Where did you hear about Wise Up Workshops?*

Name of Attendee:*
Date of Birth:*
Tel No:*
Email Address:*
Home Address:

In case of Emergency Contact Details (ICE):
Name:*
Relationship to Attendee:*
Tel Number(s):*

Which date(s) would you like to book?*
- Aug 22nd-26th 10am-4pm

Disabilities (Where Applicable)
Does the attendee have a disability?*
Please let us know which disability:*
Please give us further information on the disability below.*

Any Allergies / Medical Conditions:*
Anything important we need to know?*

Permissions: (Where Applicable)
Do you give permission for the person named (yourself) above to be filmed or photographed during the workshops and featured on Wise Up Workshops website & Social Media.*
- Yes
- No
Do you give permission for the Wise up team to administrate first aid if needed and understand the team will call the ICE number provided to report the incident.*
- Yes
- No
Do you give permission to be contacted by Wise Up Workshops about their events, workshops and general info.*
- Yes
- No

By checking this box I agree to all of the above*
- I agree
Date
DD slash MM slash YYYY

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