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Name of Child:.............................................................. DOB:.................................... Parent Name:............................................................... Parent Address:............................................................... ........................................................... ........................................................................................................................................…………... Home Phone :...................................................... Mobile Phone :................................................... E-Mail: .............................................. Any Specific Medical Conditions: ................................................................................................... BoatType: ........................................................... Sail No.: ................................... I accept to the terms and conditions laid out above. Parent/Guardian Signature………………………………………………………………………………. Please carefully mark the course you are applying for by circling the relevant price Courses and dates
† No sailing will take place on August 4th (Bank holiday) ‡ All Level 3 & 4 applicants must have access to a suitable boat and sea seaworthy. () Bracketed figures represent reduced rate for second and further children – please see first page for details To apply for a place on the course, please send the completed application form and course fee to: Claire Thompson, The Old Craft Shop, Leap, Co. Cork, Ireland We will not be responsible for misdirected applications. For telephone inquiries contact Claire Thompson at 028 34676 or by e-mail at cntghyc@gmail.com
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