SUP Lesson Form

Please complete our lesson booking form below, answering all questions as best as you can providing any relevant information. Upon completing, please submit at the bottom of the page. Please wait to recieve a confirmation message on this page that your submission has been received.

If you have any questions regarding this form or any of the information presented here, please do not hesitate to contact us for clarification.

First Name:

Last Name:

Contact Email:

Contact Phone Number:

Emergency Contact Phone Number:

Do you have any medical details that would be relevant to your lesson, including but not limited to Epillepsy, Asthma, Heart condition etc.:

Yes No

If yes, please provide details:

If you have a gift voucher, please provide the voucher number here:

By completing this form and checking this box I agree that I have provided truthful and accurate information within this form to the best of my ability. I understand that this information is required by Adventure Sports Kitesurf Australia (ASKSA) to ensure my safety and satisfaction. I understand that ASKSA, its associated agencies and instructors cannot be held liable in the event of an incident or personal injury during the activity and agree to release said parties from any legal responsibility relating to the above activity. I participate having had the risks fully explained and accept responsibility for my participation. I agree to abide by the directions of the instructor/guide at all times to ensure both my safety and the safety of others. I understand that it is at the discretion of ASKSA to cancel the activity for any reason. If an activity has to be cancelled by ASKSA, I understand I will be entitled to a full or partial refund at the discretion of ASKSA. ASKSA may charge a cancellation fee of up 25% on any booking cancelled within 48 hours of the scheduled date. I understand that ASKSA keep all information on this form in accordance with the Privacy Act.

Confirmation:

I have read all the above terms and conditions, fully understand them and agree to them where indicated. I have completed this form myself in my own name, or am doing so on behalf of a minor as their legal guardian. I agree and understand that completing this form and submitting it here electronically I am providing an electronic signature consenting to and authorising this agreement.

Notes:

SUP Lesson Form

Confirmation:

Your Order