DofE Gold Residential Booking - Bentley Copse | Outdoor Activity Centre Surrey

DofE Gold Residential Booking Form

Please complete this form to provide the required details for your DofE residential booking

About You

First name

Surname

Age at start of residential

Date of Birth

Address

E-mail Address

Mobile Telephone Number

Membership / eDofE ID

DofE Centre

Your Medical Details

Doctor's Surgery Details

Medical Conditions and Allergies

Medications

Dietary Needs

Additional Support Needs

Arrival / Departure Details

How will you be arriving and departing our site? If you are planning to have your vehicle park onsite here with you during the residential you must include your registration number below:

Travel Details

Emergency Contact Details

We require two sets of details which we shall only use in event of emergency.

Emergency Contact 1

Emergency Contact 2

Terms and Conditions

Terms and conditions

I understand by submitting this form that it forms the basis of my booking and that all information on this form is filled in and is accurate.

I have read and understood the terms and conditions.

I confirm I will follow all site rules and instructions.

I confirm that I give permission in the event of emergency for Bentley Copse staff to deliver medical treatment / first aid which may if necessary include transport to a medical facility and treatment by medical practitioners.

Can we keep in contact?

We like to keep our customers up-to-date on our latest products and to let them know about any special offers. If you would like to get these emails please check the box.

Check for email confirmation
A confirmation email will be sent immediately upon submission. Please check your inbox for this.
If you do not receive this confirmation within a few minutes please email bookings@bentleycopse.org.uk with your booking request.