APPLICATION FORM
Your Name	Please Select Mr Mrs Ms
Age
Address
Postcode
Country
Email
Do you wish to be placed on our news letter list?	yes      no
Telephone Day
Telephone Evening
Which course are you applying for?	Please select CW 01 CW 02 CW 03 CW 04 CW 05 CW 06 CW 07 CW 08 ---------- SP 01 SP 02 SP 03 SP 04 SP 05 SP 06 SP 07 SP 08 SP 09 SP 10 SP 11 SP 12 SP 13 SP 14 SP 15 SP 16 SP 17 SP 18 SP 19 SP 20 SP 21 SP 22 SP 23 SP 24 SP 25 SP 26 SP 27 SP 28 SP 29 SP 30 SP 31 SP 32 SP 33 SP 34 SP 35 SP 36 SP 37      second choice Please select CW 01 CW 02 CW 03 CW 04 CW 05 CW 06 CW 07 CW 08 ---------- SP 01 SP 02 SP 03 SP 04 SP 05 SP 06 SP 07 SP 08 SP 09 SP 10 SP 11 SP 12 SP 13 SP 14 SP 15 SP 16 SP 17 SP 18 SP 19 SP 20 SP 21 SP 22 SP 23 SP 24 SP 25 SP 26 SP 27 SP 28 SP 29 SP 30 SP 31 SP 32 SP 33 SP 34 SP 35 SP 36 SP 37
If your course is fully booked do you want to be placed on a waiting list?	yes       no
Please state the standard to which you climb:	leading:           seconding:
Further experience
For multi activity/canoeing courses all applicants must be able to swim. Please state ability:
Are you sure you are physically fit to take part in the course you are applying for?	yes         no
Please indicate any disability:
Notes on courses at Compass West. Climbing/Mountaineering and Outdoor Pursuit has a certain amount of risk and danger involved with it, and although we take every care to minimize these risks, participants should realize that accidents are possible. Where appropriate parents and students should consider this aspect of their participation in our courses. It is highly recommended that personal insurance be obtained. Click here for our recommended insurer or click on the link after completing this form. UNDERTAKING: I have read the notes above and understand that deposits are not returnable once a place has been booked for me at Compass West. Its instructors and staff are not liable whatsoever in respect of any loss or personal injury which I may sustain whilst on a holiday or course. agree disagree I agree to the terms of cancellation. agree disagree For applicants aged 17 years old or under For Spanish courses we require a signature of a parent or guardian. For UK courses all applicants under 17 yrs old must be accompanied by an adult. Do you have a friend who would like to come on one of our courses? Fill in their name and address below and we will send them one of our brochures or our web address.
name
address
email
Paymen: A non returnable deposit of £85.00 to secure a place. Balance to be paid 6 weeks prior to course.  Send a cheque to: Rowland Edwards -Treeve Cottage -Sennen -Penzance -Cornwall -TR19 7AD. Or apply for bank transfer details