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Personal Information Form

Please complete fully and return as soon as possible, prior to arrival on course.

Participant Details

In order to assist us in planning your activities and providing the correct equipment please supply:

Important Contacts

Emergency Contact


Medical Information

The information held on this form will be treated as confidential and is only required in order to ensure that we are able to give appropriate medical support if required.

Please answer all questions fully and honestly. If on arrival it is found that any information has not been given correctly then we reserve the right to refuse participation.

People over the age of 45 have a higher risk of heart problems, fractures and other conditions, if they suddenly take up moderately demanding physical exercise of any kind. This is particularly true for people who do not take regular exercise or who are over weight. If you are concerned about your physical suitability for the course, please seek advice from your doctor and obtain written confirmation that it is appropriate for you to participate.

1. Heart trouble?2. Asthma, bronchitis, tuberculosis?3. Diabetes?4. Epilepsy, fainting attacks, migraine, severe head injury?5. Nervous illness or psychiatric treatment?6. Allergy to foods (eg nuts)?7. Other allergic reaction (eg hayfever, or reaction to medicine or insect bites)?8. History of fractures or tendon/ ligament damage (eg back, neck, arms, ankles or knees)?9. A tetanus injection? If so specify most recent date.10. Are you suffering from, or are you a carrier of, any infectious disease?11. Have you been treated by a doctor within the last two years?12. Are you taking any medication? If so please give details, state dosage, and ensure that you bring adequate dosage with you.13. Do you have any specific dietary requirements (eg vegetarian or vegan)14. Do you have, or suffer from any other medical or physical condition

If you answered yes to any of the above, please provide more information here

If there are any changes to the above, you must inform us prior to taking part in any activity.

I declare that all medical and enrolment information on this form is true and that I have not withheld any relevant information. For under 18s a parent or Legal guardian must sign.

Book This Activity Now

Please contact usĀ on 01768 489125 or email for further details on any of our caving courses or services. All quotes are provided on an individual basis, according to your specific requirements.

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