Event Name: / As per CSSC Website
Date of event:
Start time:

Please complete all sections in BLOCK CAPITALS if writing by hand. CSSC membership numbers must be included. You may find it helpful to‘Tab’ from one field to another.

Section 1: Your Details- Lead attendee (Delete as applicable)

Title: / Forename: / Surname:
Gender: / DOB:
Home Address
Postcode
CSSC membership no.
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin Name / NoK Contact Tel. no.

Section 2: Other Attendees

Please complete ALL details below for any attendees

Name / Adult/child
and age / CSSC number
(if applicable) / Contact
Number / Email Address / NOK and contact
number if different

Section 3: Other information or extras

Section 4: Medical and Dietary Requirements

Medical: Please let us know if you or any of your group have any physical or medical conditions

Yes/No (Delete as applicable)

If yes, please give details
Any Dietary Requirements

Section 5:How to apply

Please send all entries to:

Email:

Post: CSSC Taster Events, Compton Court, 20-24 Temple End, High Wycombe, Bucks, HP13 5DR

Please do not pay until confirmation is received regarding availability. Payment in full will then be required within a week of the confirmation email.

To pay by card please call 01494 888434 quoting the name, date of event and amount to be paid.

All chequesshould be made payable to ‘CSSC Ltd’ and should accompany the entry form. Please do not send cash.

Bank Transfer is possible for any payments over £100.00, please email for these details.

Refund Policy: No refunds will be given from a month prior to the event.

Payment Method: / Total Amount: / £

IMPORTANT: Please note that some of these events are active and attendees should be aware of the physical activities involved.

CSSC reserves the right to cancel the event if under subscribed. In the event of cancellation by CSSC a full refund will be provided and as much notice as possible will be given.

All CSSC members taking part in the event are covered by the relevant venue’s Public Liability Insurance. CSSC has made sure that this is in place and is sufficient. Please note that this policy is NOT a Personal Accident Policy. Members are encouraged to take out their own insurance policy.

This event is open to your friends or family members via out Linked Membership Scheme. Up to three of your friends or family members can join CSSC and take part in our events at members’ rate. Membership is also available to staff working in the Public Sector such as NHS, local government, teachers, the police, fire fighters and HM Armed forces personnel.

Once entry forms and payment are received and processed an acknowledgement email will be sent out with further information a week or two before the event.

Signed: Date: