Booking Form – Sailing Therapy

Dates(s):		Cost:
What time would you like to arrive?:		What time would you like to finish?:

*Person in charge information

Title:

First name:

Last name:

Company name (if appropriate):
Address:
Postcode:

On shore contact telephone number:

E-mail:

*Participant information

Number of adults(18+):

Number of under 18s:

Ages of under 18s:

Care homes only

Number of service users:

Number of escorts:

Driver's name:

Contact number:

*Disability information

Number of wheelchair users (max 4)

Please give information about any disability, current medical treatment, illness or medical condition
(e.g. Asthma, Epilepsy, Diabetes or Hearing Condition). If none, please write “None.”

For Data Protection purposes we must ask you to agree to data being stored for Administration purposes and for permission to receive future notifications. No information is passed on to a third party without seeking your specific consent.

Please tick the box to indicate that you agree.

We would like to use photos for publicity.

Please tick if you agree to having your photo taken and used.

YesNo

Signed:

Date:

Booking Terms & Conditions

Booking forms:

Please send forms as soon as possible. You are advised to check availability with David Weinstock (07773 849747). Your booking will not be accepted until a booking form has been received.

Cancellation and no show:

If you have to cancel, please let David know as early as possible. At the discretion of Sailing Therapy, a handling charge of £10 per booking may need to be paid.

Transfers:

We understand that under some circumstances, you may need to postpone your booking. We will transfer your booking to an alternative date where possible.

Medical status:

We provide a service for people that have many different medical conditions and while this is not necessarily a restriction on your activities with us, we ask that you give an outline of relevant medical problem, e.g. epilepsy, heart condition etc, so that we can ensure adequate provision is made.

Wheelchairs:

Rebecca Anne can accommodate up to four wheelchairs within the available ten places. Electric wheelchairs weigh about the same as a person. They also take up more space and so may restrict the number of participants. Please consult the Sailing Therapy team if you are intending to bring an electric wheelchair.

Refreshments:

There are basic galley facilities available for the provision of hot and cold drinks, but we do not provide meals.

Times:

Day time bookings are between 10:00 and 17:00, and evenings between 18:00 and 20:00. If you wish to divide you booking between more than one group, then discuss this with the sailing therapy team.

Fees:

The charge is for the boat with space for up to 10 people including escorts. This is for the duration of your chosen booking. Payment is due within one calendar month of your trip. Where it has been agreed that an invoice will be issued, within one calendar month of receipt of the invoice. Payment can be made by cash on the day (receipts can be issued), cheque made payable to ‘Sailing Therapy C.I.C.’, or by bank transfer to:

Account name: ‘Sailing Therapy C.I.C.’,
Bank: ‘National Westminster’,
Sort code: ’60-05-24′,
Account number: ‘20707762’.
Reference: Supplied with booking confirmation

Escorts:

The ratio of escorts to service user is at your discretion. We may not know your service users and so depend on you to send appropriate escorts.

Crews:

Sailing Therapy will provide appropriate crew to run the boat. We do not provide bare boat charters.