THECANOEMAN OVERNIGHT BOOKING FORM

Date of Arrival:

to

Site:

Office Use

Initial

Diary

Camping Diary

Deposit

Balance

Template Email

Reminder Email Set

Transaction No

Trail/ Activity (ie bushcraft canoe trail):

Group Leaders Details
Title/First Name/Surname:
Tel No:

Mobile No:

Address:

E-Mail:
Emergency Contact Name:
Relationship:
Emergency Contact Number:

Postcode:
Age, only if
Name of Participant
Under 18
(Including Leader)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Please specify arrangement of boats:
(2 or 3 man canoes, single or double kayaks)

Accommodation Information
Canoe or Tipi Camping Trail Only
No. of people:
No. of nights camping:
No. of days paddling:
No. of tents you are using:
Medical Information Within The Group
Any past/relevant illnesses/injuries
Any past/relevant medical treatment?
Any allergies? (medicines, food, bee stings etc)
Any special dietary requirements?
Any disability?
Details:

Name of Participant

Age, only if
Under 18

11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

Tipi/Tent Hire (Or N/A if using own)

Size of tent required:
Camping equipment for 4 people required: Yes/No
PLEASE NOTE any damage to equipment hired must be
paid for and will be debited to the credit/debit card used to
make this booking.

Yes/No If Yes, please give name and details below

Yes/No If Yes, please give name and details below
Yes/No If Yes, please give name and details below
Yes/No If Yes, please give name and details below
Yes/No If Yes, please give name and details below

Please Note: Staff are not permitted to give medication or painkillers.

Please give any further information you feel may be of use in an emergency or that our instructors/
guides should be aware of e.g. phobia, hyperventilation, diabetes, epilepsy, motion sickness, back
injuries etc.

BOOKING CANNOT BE PROCESSED WITHOUT PAYMENT

50% payment required immediately upon booking, balance to be paid within 1 month of course date for all group
payment over 100. If hiring camping equipment please include 25 per person refundable breakages.
All group payment under 100 must be paid in full at time of booking.
Please make cheques payable to Norfolk Broads Tourist Information & Activity Centre: amount included:
of total amount send to Norfolk Broads Tourist Information & Activity Centre, 10 Norwich Road,
Wroxham, NR12 8RX
BACS transfer: sort code: 20-99-21, acc. no: 93475336 for the appropriate amount: please reference with your name
and date of booking. Amount transferred: of total amount .
Statement of Assumed Risk
To minimise these risks we have evolved a safe system of work
We only employ fully qualified staff
We provide appropriate personal safety equipment for all participants
We provide appropriate equipment for the course
We work to National Governing Body guidelines in respect of instructor to student ratios
We have a robust risk management system in place
We reserve the right to cancel or modify any activity if we believe there to be adverse risk ie adverse weather
Anybody thought to be under the influence of alcohol or drugs will not be allowed to participate
Maximum payload per 3 seater canoe is 36 stone
For your safety and comfort we advise you bring sufficient food and drink with you and you read any joining
instructions and kit list carefully to ensure you bring the correct clothing and footwear.
Swimming ability: All participants taking part in water activities are equipped with buoyancy aids; therefore an inability
to swim will not exclude you from taking part. However we do ask that you have a certain level of water confidence
relevant to the activity. If you have any concerns about this please discuss it with your instructor.
We fully understand that there are certain dangers involved in the use of a kayak or canoe that are beyond the control
of TheCanoeMan and its employees, which may result in accident, injury, death or property damage either to myself or
other persons. Such dangers include, but are not limited to, the possibility of capsizing which could result in drowning,
the possibility of striking rocks or other objects which may damage or rupture the boat and the possibility of being
exposed to the hazards of water level or weather changes (including rain, lightening, fog, high winds and rough water)
which may cause hypothermia.
Data Protection Act 1998: The information you supply to us will only be used to process your booking and for our
mailing list. If you DO NOT wish to receive further brochures or information, please tick the box.
Cancellations/Refunds All deposits are non-refundable and that no refunds will be issued for early returns, illness,
weather or non-usage. Cancellations less than 5 weeks before the start day 40% of full payment will be refunded.
Cancellations less than 3 weeks before the start day 25% of full payment will be refunded. Cancellations less than 2
week before the start day no refunds will be made.
Loss or Damage. Be responsible for, and indemnify us against, loss of or damage to, or caused by the Goods whilst in
your possession howsoever caused, and notify us as soon as practicable of any such loss or damage. We understand
we are liable for all dirty, damaged, lost or stolen equipment and any fees associated with the listed equipment, and that
all equipment must be returned in good condition as determined by the TheCanoeMan. We accept no responsibility for
consequential loss or damage howsoever arising from the letting evidenced by this agreement unless it arises from our
negligent act or default.
We occasionally take photographs which may be used in future articles or advertising material.
If you DO NOT wish to photographed, please tick the box.
Please note if you are signing this form on behalf of a group which you are organising, you are confirming that all
members of your party have fully read and understood the terms and conditions attached to this booking and that they
are happy for you to sign on their behalf and that you have disclosed all relevant information relating to the individuals in
your party (in particular health questions). If acting on behalf of a group who are booking a self guided trip we ask you to
consider whether your group / club or you as the organiser has any liability in the event of an accident or fatality - if so
you may wish to consider allowing us to provide you with a guide / instructor at which point the liability becomes ours.
I have had brought to my attention the Terms & Conditions relating to this booking, in particular, those concerning
cancellation.
I understand that booking is accepted on the understanding that Activ-8 Adventure/ TheCanoeMan/ Norfolk Broads
Tourist Information and Activity Centre, safety regulations are observed.
I accept that Activ-8 Adventure/ TheCanoeMan/ Norfolk Broads Tourist Information and Activity Centre, is not under any
liability whatsoever in respect of loss or damage to personal property, not caused by negligence or default of Activ-8
Adventure/ TheCanoeMan/ Norfolk Broads Tourist Information and Activity Centre, its suppliers and its agents whilst
attending the course.

Print Name:
(Parent or Guardian to sign if under 18)

Signature:

Any further questions do not hesitate to contact us on: 0845 4969177

Or email: info@TheCanoeMan.com

Date: