Mary Gray Narrowboat Holidays Course Registration Form
Costs:	Cost or Tick
HELMSMANS COURSE, at £110 each. (Max 3 persons)
ICC course including CEVNI test, at £140.
OWN BOAT TUITION, as agreed.
CEVNI theory test by itself, at £25.
Total Cost.
Please complete details. Name(s).................................................................................................................................... Address .............................................................................................................................. .............................................................................................................................................. .............................................................................................................................................. Postcode ..............................................................Age if under 18............................... Home Phone No............................................ Email ................................................... Mobile No............................................. Emergency, Next of Kin Contact No............................................... Please reserve a place on the following date: ......................................... I enclose a cheque for £ ..................................... in payment of course fees. Please make cheques payable to: Mary Gray Narrowboat Holidays Lunch is not provided though hot drinks are. Students may use the galley facilities on the boat. If I suffer from epilepsy, disability, giddy spells, asthma, diabetes, angina, or other medical condition I will tell the School. I am medically fit to participate in the course. I accept the course booking conditions Signature .................................................................... Date ..........................

Please print of this form, complete sign and date and return to :- Mr A Bell, Overton Green Farm, Smallwood, Nr Sandbach. Cheshire.CW11 2UP.