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SURF school wales

ABERAVON BEACH, PORT TALBOT

MEDICAL FORM

Every customer must complete this medical form for 2020 lessons. You only need to complete it once for the 2020 season. Under 16's must have this completed by parent/guardian.

First Name

Date of Birth

Phone

Last Name

Do you have any medical conditions

Name of emergency contact

I declare that the info I’ve provided is accurate & complete

I agree to theterms & conditions

Contact number for emergencies

Date of your lesson

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