How many people is this experience for?

Participant 1's Details

Title: Forename: Surname:
Date of Birth (must be over 16): Age:
Home Address:
Postcode:
Phone:
Email:
Preferred T-Shirt Size
MediumLargeExtra Large

The participant is required to be up to date with their tetanus vaccinations. Please can you confirm that their vaccinations are up to date Yes

Please give details of any allergies we should be aware of
Please give details of any special needs we should be aware of
Please give details of any medical conditions we should be aware of

Participant 2's Details

Title: Forename: Surname:
Date of Birth (must be over 16): Age:
Home Address:
Postcode:
Phone:
Email:
Preferred T-Shirt Size
MediumLargeExtra Large

The participant is required to be up to date with their tetanus vaccinations. Please can you confirm that their vaccinations are up to date Yes

Please give details of any allergies we should be aware of
Please give details of any special needs we should be aware of
Please give details of any medical conditions we should be aware of

Booking Information (all information is confidential)

Please give 4 possible dates you would like to be Keeper for the Day

Date No. 1
Date No. 2
Date No. 3
Date No. 4

Emergency Contact Information

(this information is for use on the day of the experience – hopefully not needed!)

Emergency Contact Name
Emergency Contact Number

Fee Payer details

(the person who will be paying for the experience if different from participant)

Title: Forename: Surname:

Home Address:
Postcode: Phone:
Email:

I agree to abide by, or to inform the person whom I have booked this experience of all the Health and safety rules.


Please ensure you have ticked the checkbox above to enable you to send the form