Paddler Info Form | Breakwater Coaching

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Paddler Information Form

First name*

Last name*

DOB

Day

Month

Year

Email*

Phone

Address: No. & Street

Town

County

Postcode

Next of Kin

Next of Kin Contact no.

PaddleUK membership no.*

Date started paddling?

How often do you paddle?

Which, if any, board/craft have you?

Do you suffer any health or other needs?

Have you any paddle related qualifications?

Paddling Weaknesses?

Paddling Strengths?

What are your short term paddling aims?

What are your long term paddling aims?

What do you want from your session?

Skill level*

Beginner (<15hrs)

Intermediate (15 - 50hrs)

Experienced (>75hrs)

Can you swim 50m?.

Can you self rescue?.

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