Charity Event Booking

(Fill in this form ONLY if a charity is hosting an event in which One Spark Outdoor Adventures are the appointed company to lead the event but you are NOT making payment to us directly)

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Course / Activity name – Select one option

Date of event (or preferred date if not already fixed) (DD/MM/YYYY)

I CAN BE FLEXIBLE ON THE ABOVE DATE (IN CASE OF BAD WEATHER ETC) – WE WILL BE IN TOUCH IF NECESSARY TO DISCUSS – Select one option

PERSONAL DETAILS:

Full Name

Address

Post Code

Contact Phone No

Age

Date of Birth (DD/MM/YYYY)

Email address

EMERGENCY CONTACT DETAILS:

Emergency Contact Name

Contact No.

Relationship

MEDICAL INFORMATION:

The following medical questions are not intended to prevent you from taking part in any event but are asked so that we can best look after your safety and wellbeing while in our company.

Has a doctor ever said you have a heart condition, and you should only engage in physical activity recommended by a physician?

Do you / have you ever suffered from chest pains during physical activity?

Do you ever lose consciousness / balance for any reason including dizziness?

Have you ever been told by a doctor that you have a joint or bone problem that may be made worse by physical activity?

Are you pregnant?

Have you had recent surgery?

Are you currently taking medication medication for blood pressure or heart conditions?

Are you currently taking any other regular prescribed medication?

What medication are you taking, what is it for, and what dose?

Do you have any other medical conditions which we should be aware of? If ‘Yes’, please state:

Do you know of any other reason you should not exercise or take part in physical activity?

MEDICAL DECLARATION: I have answered the medical questions to the best of my ability and affirm that my physical condition is good, and I have no known conditions that would prevent me from participation in the course or activity I have chosen. I understand that by signing this agreement that I hereby waive and release One Spark Outdoor Adventures and all relevant staff in any way from liabilities or demands because of injury, loss, or adverse health conditions because of my participation. I have read and accept the terms and conditions and wish to apply for the above course/activity:

TERMS & CONDITIONS:

1. Insurance – Andy Lindsley at One Spark Outdoor Adventures is a Qualified Mountain Leader (MTA 291063) and holds public liability and professional indemnity insurance (Sportscover Policy no. PLON99/01116816). It is recommended that you take out your own personal accident insurance that will cover you for personal injury and personal possessions if you require.

2. Extreme Weather – Courses/activities will go ahead in all weathers unless deemed dangerous by One Spark Outdoor Adventures.

3. Responsibility – Persons using tools, when relevant, will be expected to consider the safety of others as well as their own. Dangerous behaviour will result in a caution, or, if necessary, dismissal from the course.

4. Repairs – Individuals are liable for the cost of repairs made necessary by wilful damage to equipment or to Landowner’s property.

5. Risk – One Spark Outdoor Adventure would like to remind you that participating in outdoor and adventurous activities in mountains or woodland involves an element of risk. You will be supervised by a highly qualified instructor and risk is continuously assessed but such activities can be hazardous, and accidents can occur. During some courses/activities you will be in a woodland environment and cooking on open fires. It is therefore quite possible to burn, stain or otherwise damage your equipment and or clothes. One Spark Outdoor Adventures can take no responsibility for the condition of your, or anyone else’s, personal belongings you may bring with you.

6. I have read and accept the above terms and conditions:

DISCLAIMER:

Please now read, understand, and agree to the following statements:
1. I will be provided with a kit list and understand that the items on that list are essential for my comfort and safety during the event.
2. I have completed an online medical form detailing any medical conditions that I have, if applicable.
3. I will be expected to adhere to any instructions given to me by the leaders employed by One Spark Outdoor Adventures. In relation to hiking activities, this includes not separating myself from the group and having one of the leaders in sight throughout the event. I understand that this is for my own safety.
4. I can confirm that I will be properly equipped, in accordance with the kit list provided, will adhere to any instructions given to me by any of the leaders regarding my safety, have no medical conditions which I have not disclosed, and have not been told by a medical professional that I should not take part in the event.
DECLARATION:
1. In addition to the terms and conditions already agreed to on the booking/medical form I have completed, I agree to waive and release One Spark Outdoor Adventures Ltd, and all relevant staff, from any liabilities or demands caused by me not being properly equipped, having failed to disclose any medical conditions or take the advice of a medical professional with regard to taking part in this event, and failing to adhere to any safety instructions given to me by the leaders during the course of this event.
2. I have read, understand and agree to be bound by the terms of the disclaimer and now which to apply for this event:-