Site Skimming Course Booking Form 2020 Contact Details:

Title: Gender:

Surname: Date of Birth:

Forenames: NI Number:

Address: Home Tel No:

Mobile No:

Postcode: Studied at Train4All before: Yes No

Email:

Course Details:

Course Title Centre Location Start date: Planned end date:

British Gypsum Site Skimming Course.

Train4All Academy, Somerton

Preferred Contact Methods:

Email Text Phone Post Employer details (if applicable):

Previous qualifications (if applicable):

Qualification Title Level Date Achieved

Qualification Title Level Date Achieved

Other Information:

Do you have a learning or social need which might impact your learning or final assessment? If so, please provide details here so we can provide any additional support required:

Employer Contact Name

Address Tel Number

County Email Address

Postcode

Images Consent: From time to time, we may take appropriate images and videos of delegates and their work to use in our printed and online publicity. We would be grateful if you can please complete the following to either provide or decline your consent to do so: Surname:

First Name:

Address: Date of Birth:

Course: Site Skimming Course

Permissions: Please tick I give permission for Train4All to take photographs and videos during my time at Train4All

I do not give my permission for Train4All to take photographs or videos

I grant full rights to use the images resulting from the photography/video filing, and any reproduction or adaptions of the images for fundraising, publicity, to assist in the marketing of Train4All. Including (but not limited to) the right to use them in printed and social media publicity, press releases and funding applications.

Medical Information: For completion by all delegates attending Train4All. If you are under 18 please ask a parent/guardian to complete and sign this form before returning to the Main Office.

Next of Kin and Emergency Contact: Contact 1:

Relationship to you:

Tel No:

Alternative Tel No:

Contact 2:

Relationship to you:

Tel No:

Alternative Tel No:

Medical and Dietary Details: GP Name:

GP Tel No:

GP Address:

Please give any medical conditions/disabilities/injuries e.g Diabetes, Epilepsy, Allergies etc: Will your conditions prevent you from carrying out your chosen training? Yes No Please provide details if you answered yes:

Are you receiving any current medical treatment, including medication: Yes No Please give details if you answered yes:

Are you able to manage your own medication: Yes No Please give details if you answered no:

Do you have any special dietary needs: Yes No Please give details if you answered yes:

In the case of an injury to a delegate on the premises, First Aid will be administered by a qualified, Train4All First Aider where appropriate and required. Train4All will contact the emergency services and the above emergency contact person will be notified. If you wish to discuss your medical history further and confidentially with a member of the Train4All team please tick here. I can confirm the information I have supplied is correct. I understand the details on this form will be used by Train4All and it is my responsibility to inform Train4All of any changes. I am happy for Train4All to contact me to discuss any of the above if required. Booking Terms & Conditions:

1. Bookings: All bookings are provisional until full confirmation has been received. 2. Fees, cancellations and postponements: A confirmation of booking will be sent within 7 working days of receipt of completed booking

form. 3. Course joining instructions will be emailed 14 working days prior to your course start date. 4. Course changes: Train4All reserve the right to make amendments to the published programme or adjust booking arrangements if

necessary. 5. Liability: Any expressed or implied statement, condition of warranty statutory or otherwise, not stated herein is hereby excluded and

deemed to be inconsistent herewith. No responsibility is accepted by the seller for any damage or loss arising directly or indirectly from the course supplied.

6. Force Majeure: The acceptance of a booking may be revoked (in whole or part) or course dates postponed by us without liability in the event of any contingency beyond our control that does, or is in our opinion, likely to prevent, hinder, delay, interrupt or interfere with the fulfilment of the order or any part of it.

7. Clothing: You are required to provide suitable work clothes and protective footwear for your course at the centre and for onsite assessment in order to meet legal Health & Safety requirements, entry to workshops is prohibited without appropriate PPE (personal protective equipment).

I confirm I have received advice and guidance for the above course and I have read and understand the above terms and conditions. Delegate Signature: ____________________________________ Date: _______________________

Please return your completed form via email to kirsty.woods@train4all.co.uk or, via post to: Train4All, Units 1-4 Jubilee Park, Badgers Cross Lane, Somerton, TA11 7JF PERSONAL DATA Train4All is committed to data security and the fair and transparent processing of personal data. Our privacy policy sets out how we will treat the personal data which you provide to us in compliance with applicable data protection law, in particular the General Data Protection Regulation (EU) 2016/679 (GDPR). It contains important information regarding who we are, how and why we collect, store, use and share personal data, your rights in relation to your personal data, how to contact us and supervisory authorities in the event you would like to report a concern about the way in which we process your data. If you wish to view this policy please contact our Data Administrator at Data@train4all.co.uk

Print Name:_________________________________ Signed:____________________________________ Date:_____________________