Course Registration — GoodWave Adventures

Name

First Name

Last Name

Email Address

Select Course

Contact Number

Country

(###)

###

####

Age

Sex

Male

Female

Height

Please indicate your height in either cms or ft.

Weight

We need this data to ensure that we allocate the kayak that is the best fit for your height and weight

Can you swim 25 meters unassisted ?

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

Country

(###)

###

####

Medical Conditions/Ailments

Please list out any medical conditions or Ailments that you suffer from. This information will be treated as confidential

How did you hear about Goodwave Adventures ?

Facebook page/Website

Friend or Family member

Chennai Trekkers Club

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Do you wish to subscribe to the Goodwave Newsletter

Yes

No