Angling Coaching Registration Form                                                                                                      Please do not let the paperwork put you off, fishing is fun but a certain amount of paperwork is necessary to make it legal, safe and keep things running smoothly. (All information given below will be treated in strictest confidence and is only required for administration and in case of emergencies) Name……………………………………………………………………………………………….......................................... Address…………………………………………………………………………………………….......................................... Age………………Date of Birth   ………………………………………………………....................................... Telephone numbers (In case of emergencies a contact number where a relative or guardian may be contacted on the day of and at the time the course is taking place is required).                                                                                 Home number………………………………………………………Mobile number…………………………………………....   Emergency Contact numbers (If different from above)…………………………………………….................................     Do you have any medical condition, suffer from any allergies or disabilities that could cause you any problems whilst fishing?……………………………………………………………………….................................................................... ………………………………………………………………………………………………………........................................        Do you take or require any medications or carry an SOS talisman………….................................. ……………………………………………………………………………………………………….........................................  Name, address & telephone number of your Doctor………………………………................................... ………………………………………………………………………………………………………......................................... Your Professional Anglers Association Instructor has satisfactorily undertaken a first aid at work course to satisfy the requirements of the Health and Safety (First Aid) Regulations 1981 and has been assessed as competent.          Do you grant permission for your instructor to administer first aid to yourself or your child should the need arise (yes or no)…………….......................................................................................................................................... and to seek professional medical assistance (doctor, ambulance, hospital etc.) should the need arise (yes or no)…………………………………………………………………………………….....................................................     Do you possess an Environment Agency Rod Licence (yes or no)………………………………….  If the answer is no for £1, I can supply an EA non migratory trout & coarse fish rod licence which covers you whilst you undertake your first coaching session, (Not required by Under 12’s).                                                                                          As an angling correspondent Chris regularly photographs his clients, a photograph capturing that first fish or a personal best can speak a thousand words or silence those doubter’s. Could Chris use any photographs of you or your child, taken whilst fishing in any angling publications, newspapers, on Chris’s website or in other angling publicity material, brochures etc. Addresses would not be published. (Yes or No)………………………………......        In the interests of safety anyone undertaking any of the Chris Bowman Fishery Management Angling Courses, Guided trips or Corporate days must follow the guidance and advice given to them by their instructor. In order to demonstrate some angling techniques physical contact may be necessary, your instructor will tell participants when and explain why this may occur. Disclaimer: Chris Bowman cannot be held responsible for any loss or damage incurred to personal property or vehicles by anyone attending a Chris Bowman Fishery Management Angling Course, Guided Trip or Corporate Day.                                                                                                                           Name of course or guided trip you are interested in………………………………………………....................................  1^st Choice of dates of course……………………...............2^nd Choice of dates of course……………………................ I have read and understand the terms and conditions laid out above, signed………………………………………………………………………………………………........................................      (A parents or guardians signature is required here to give children their permission to take part in a course or guided trip) Please send completed forms and payment, cheques payable to Chris Bowman), to Chris Bowman, Crosshill Cottage, Blackford, Carlisle, CA6 4DU. Tel: 01228 674519 Mobile:07714168939.