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Course Registration Form

Please complete details.

Name(s)....................................................................................................................................

Address ...................................................................................................................................

...................................................................................................................................................

..................................................................................................................................................

Postcode ..............................................................Date of Birth.........................................

Home Phone No............................................  Email ..........................................................

Mobile No............................................. Emergency, Next of Kin Contact No...............................................

Please reserve a place(s) on the following date: .......................................................

I enclose a cheque for £ ..................................... in payment of course fees.
Please make cheques payable to: Inland Waterways Cruising School.

The School is able to conduct courses on the canal, the river, or both. Please indicate your interest.

Canal………………….. River………………….. Both……………………

The School can then adjust the course content accordingly. If the river is in flood it will not be used as part of the course.

If I suffer from epilepsy, disability, giddy spells, asthma, diabetes, angina, or other medical condition I will tell the School. I am medically fit to participate in the course. I accept the course booking conditions



Signature .................................................................... Date ..........................