Your Name
Your Email
Your Contact number
Your Activity Choice First Aid - 4hr BasicGuided mountain walkMountain Adventure scrambleWeaslingWhite water kayakingBCU - 2 Star AwardBCU - 3 Star TrainingBCU - 3 Star AssessmentBCU - Foundation Safety & RescueOpen canoe journeyGorge Walking
Any specific request, eg location, add a second activity?
Your Prefered date or next available date? (We'll call you to confirm).
Number of Adults 123456
Number of Children 012345
Kit and Equipment I will use Wilderness Development's kit and equipment.I will provide all my own kit and equipment for the activity.
Your emergency contact's name
Your emergency contact's numbers
Your emergency contact's relationship to you (eg. Mother)
Does anyone in this booking have any potentially serious or unusual medical issues that could affect their ability to participate in the activity? (Asthma, epilepsy, diabetes, severe allergies etc). This will be kept strictly confidential
Have you paid already, or shall we contact you to take payment? ---I still need to pay for this booking.This booking has already been paid (I'm redeeming a voucher)This booking has already been paid (I've paid in advance)
Please enter the type and/or serial number of any voucher that you'd like to redeem.
I have read and accept the Terms and Conditions of booking.