SEASEARCH BOOKING FORM

Course: RBGE/MCS Seaweed Identification Course
Date: 7/8th June 2014 / Location: / The Hippodrome, Harbour Road, Eyemouth
Name:
Address:
Telephone: / e-mail:
I would prefer to receive information by: post / e-mail*
Age (if under 18 years):
(Anyone under 18 will need to send a parental consent form and obtain their parent's or guardian's signature on this form)
}
Please return this form to: / Education Department, Royal Botanic Garden Edinburgh, 20A Inverleith Row, Edinburgh. EH3 5LR
Signed: / Date:
Countersigned by parent or guardian for anyone under 18:
* Please delete as appropriate
Your contact details will be placed on a database which may be used by Seasearch partner organisations to send information about marine life surveys and conservation. If you do not wish to receive further mailings not directly related to Seasearch please tick here
The Seasearch organisers reserve the right to decline to accept any booking without being required to give a reason
Please complete this section ONLY if you are planning to scuba dive on the course:
Which dive club are you a member of (if any)?:
Diving qualification (and training agency):
How many sea dives have you done in total: / and in the UK (or other temperate seas):
Any existing Seasearch qualification, or experience (eg number of Seasearch dives):
Do you have any diving depth restriction? Yes / No* If yes, please give depth: ____ m
(eg for junior divers, or associated with your qualification)
Date of most recent sea dive: / Are you medically fit to dive? Yes / No*
Date of expiry of: / doctor's medical examination: / or / UK sport diver medical self-certification:
Who provides your diver third party insurance? ______
(eg BSAC, SAA, DAN, PADI) If you are not already insured, please ensure you arrange cover prior to the course.
Which decompression system do you normally use?
(eg BSAC 88 tables, Buhlmann tables, Suunto computer)
Do you have a Diver First Aid qualification? Yes / No* If yes, date:
Do you have an oxygen administration qualification? Yes / No*
To take part in Seasearch dives you need to be BSAC Sports Diver or PADI Advanced or equivalent, and to have done at least 20 dives of which at least 10 must have been in UK seas
PLEASE COMPLETE THE PAYMENT SECTION ON PAGE 2
PAYMENT DETAILS
Type of Card: Visa * MasterCard * Switch *
Card Number:
Start Date: / Expiry Date: / Security Number: (last 3 digits)
Signed: ______Date ____/____/___
*If you would prefer to pay by bank transfer please contact