Kayak hire agreement form

Full name (*)	Please enter your full name
Address / local contact details
City
State
Postcode	is not a number.
Phone/Mobile (*)	Please add a value for .
Email (*)	is not a valid e-mail address.
Fax
Date of birth
Emergency contact details
For contact purposes only, please list your accommodation/contact details for the night prior to your hire
Can you swim?	yesno
Expected life-jacket size?	smallmediumlargeXlargeXXlarge
	Medical information
Do you have any medical conditions that may potentially require treatment (including any joint problems)?	Heart conditions Pregnancy Asthma Allergic reactions Blood pressure Epilepsy
Other medical condition	Invalid Input
Please list any medications you are currently taking	Invalid Input
	Kayaking experience
How much kayaking have you done? (*)	none< 5 days5-10 days10-20 days20-30 days30 days+ Invalid Input
What type of kayak do you have most experience in?	Invalid Input
How confidently can you re-enter a kayak after capsizing? (*)	Never tried Not confidently Confidently Very confidently Invalid Input
	How confidently can you paddle in the following conditions?
Calm seas (<15 knots)	Never tried Not confidently Confidently Very confidently Invalid Input
Moderate seas (15 - 20 knots)	Never tried Not confidently Confidently Very confidently Invalid Input
Rough seas (20+ knots)	Never tried Not confidently Confidently Very confidently Invalid Input
Group size & names	Invalid Input
Proposed Itinerary	Invalid Input
	Are you aware of the risks involved with kayaking in this location? For example, risks including (but in no way limited to)
Wind & Waves (strength, direction, sea breeze, surf, rips etc) (*)	yesno Invalid Input
Risks to health (e.g. hypothermia, drowning, physical strains and exertion) (*)	yesno Invalid Input
Type of kayak to hire (*)	singledouble Invalid Input
Departure Date	Invalid Input
Additional equipment required	Invalid Input
Would you like to receive information on special deals and new tours from Freycinet Adventures?	yesno Invalid Input
Where did you first hear about these tours?	Invalid Input
I have read and understood the Conditions of Hire (*)	yes Invalid Input
I have read the Booking Terms and Conditions and Acceptance of Risk and accept them (*)	yes Invalid Input