ABERDEENSHIRE & MORAY COUNCILS IN-SERVICE

TRAINING PROGRAMME FOR

ADVENTURE ACTIVITIES

COURSE APPLICATION FORM

We cannot confirm your place on the requested course if the application form is incomplete.
Please ensure that all fields are filled.

SECTION 1

/

For Completion by Applicant

Name of applicant:
Establishment/Base name:
Establishment/Base address:
Post Code:
e-mail:
Your preferred correspondence address,if different.
This is where we will send your logbook and manual to:
Post Code:
Tel (Day): / Tel (Eve):
Course applied for:
Date(s)
Your job title or work role with the council:
Full-time / Part-time? /
Paid / Voluntary?
Budget code for course cost:
Briefly describe your work for the council and how this training will benefit your work.
I confirm that I have the necessary pre-required experience for the course I have applied for. (See course description on council’s website.)
Signature of applicant /
Date
SECTION 2 / For completion by the Head of Establishment/Line Manager:
Have you discussed this application for Training with the above employee? / Yes/No
How will this training benefit your establishment/service (please describe)?
Endorsement:
I endorse the application of the above named employee for this course and allow the course cost to be debited from the budget code shown.
PRINT NAME: / (Head of Establishment/Line Manager)
Signed: / Date:

Participant Declaration

Activity:
Name:
Address:
Date of Birth: / e-mail:
Phone no:
Emergency Contact
Name: / Relationship:
Telephone No:
Medical Information:
There are very few medical conditions that prevent people from taking part in our activities. However it is important for us to know if you have any condition that might need special consideration. Information will be treated in confidence.
Participation, Risk and Insurance:
Whilst we make every effort to minimise risk and ensure the safety of our clients, the nature of our activities means that there will usually be an element of residual risk that we ask you to acknowledge.
We also have an expectation that you will comply with safety instructions given by instructors and that you will not take unnecessary risks that might endanger you or your fellow participants. In event of conditions on the day being unsuitable to carry out the proposed activity we retain the option to alter activities to suit conditions.
Due to the nature of our activities you are recommended to make sure that you are insured in respect of cancellation or curtailment, injury, death, lost baggage or money, liability, medical expenses, rescue and repatriation.
Please sign below to acknowledge that you have read and understand the above.
Signed: / Date:
Adventure Scotland Ltd /
Tel: 01479 811411 / e-mail:
Fax: 01479 898123 / Registered in Scotland No: SC224340