Skip to main content

Hollingworth Lake Adventure & Water Activity Centre Participant Details Form

Address(Required)
DD slash MM slash YYYY
Please advice us of any medical issues e.g. asthma, epilepsy, heart conditions etc our instructors will need to be aware of prior to your activity. You can give details of any medication, if the instructor will need to carry it during your activity.

Emergency Contact Details

Declaration

Acceptance(Required)
Please note: Adventurous activities have inherent dangers that cannot be totally negated.
(Parent or guardian if child is aged under 18).
DD slash MM slash YYYY
Please tick here if you DO NOT want your / your child's photograph taken.