Airzone Kitesurfing School - IKO Instructor Training Course booking form

Full Name

Indicate courses required: (see notes on ITC supplied with this form for details).

IKO Instructor Training Course (ITC) - $1300 Preferred dates:

IKO Instructor Equivalency Course (IEC) - $750 Preferred dates:

Assistant instructor course (AITC) - $275 + US$52 Preferred dates:

Date of birth Nationality Male / Female

Your permanent address

Phone Mobile

Email

Do you have a valid first aid certificate? Yes / No

Please advise type of certificate and expiry date

How long have you been kitesurfing? What year did you start?

Can you jump and grab, ride toe side upwind, recover a board in deep water,

recover a rider body dragging, do a self-rescue in deep water. Yes / No

Can you self-launch and self-land?(we will also cover this in the AITC/ITC) Yes / No

Do you have an assistant instructor qualification? Yes / No

Are you an IKO member? If yes, please give your IKO number

Do you have teaching experience in a wind or water sport?

If yes, please describe below:

Please list below any medical conditions or medications that the course trainers should be aware of:

You must email a copy of your first aid certificate, and a signed copy of the attached IKO waiver two weeks before the course (photo from phone is fine).

Your booking will be confirmed upon acceptance of this form and on receipt of a 50% deposit by direct bank transfer – details at the bottom of this form. The balance will be due on the first day of the course. The deposit is non refundable.

Signed Date

Print your name

Please use this area or extra pages for any more information you would like to add:

Office information only:

Airzone Kitesurf School, 365 Rangiputa Road, Rangiputa, RD3 Kaitaia

Tel: 021 2027 949 or 09 408 7129 Email

Please transfer payment to Airzone Kitesurf School, account number 38 9009 0789299 00

Kiwibank Limited, Wellington, New Zealand - SWIFT code CITINZ2X