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Please complete and sign
the following consent form before applying for any of the courses
supplied by Mindworks Technologies.
| Name: (Mr./Miss/Mrs./Ms) |
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| Date Of Birth: |
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| Address: |
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Postcode________________________________________
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| Telephone (home/work/mobile) |
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| Email Address: |
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| Course Chosen: |
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| Course Start
Date: |
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I understand that any type of physical training
or course can involve some element of danger, either in terms of
hostile environments or in my own physical state of health. I declare
that I am physically fit and agree to abide by terms set out overleaf.
I sign the following as having read the aforementioned
terms
and conditions.
| Signed:_______________________________ |
Date:_________________________ |
Please complete this form, and post
it, along with any deposit to the address listed below :
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