Medical Declaration Form

Please declare any medical / physical or mental conditions, illnesses or allergies from which you currently suffer. Please include relevant medication / treatment regime.
Also state specific concerns in your ability to cope with heights, exposure to cold, sun or water. (Required)

Active Outdoor Pursuits Ltd accepts its responsibility to make its activities as safe as is reasonably practicable. However, adventurous activities are inherently hazardous and cannot be completely risk free, however hard we try.
Accidents can happen without any contributory negligence from Active Outdoor Pursuits Ltd or its staff. The centre can accept no responsibility for loss or damage to personal property or for personal injury not arising as a result of its own act or default.
I understand and accept the above statements and accept that I have a responsibility to take careful note of instructions and to act in a way that will minimise the likelihood of injury. I am fit for the activity and will inform the centre before the course of any special medical conditions that might affect my safety.
By dating and competing the digital signature field below, I agree that I have read, understood and agree with the booking terms and conditions.
THIS INFORMATION WILL BE TREATED WITH THE STRICTEST OF CONFIDENCE

Data Protection Statement
Active Outdoor Pursuits take your privacy seriously and will only use your personal information for the purpose(s) for which you have provided it and to ensure our legal and professional obligations to provide safe outdoor adventure experiences. We will never share your information with third parties.

We would like to contact you occasionally with details of other activities, new courses or special offers. If you consent to us contacting you for this purpose, please tick to say how you would like us to contact you:

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You can view our full privacy statement at the this page.

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