Kayak hire agreement form
Full name (*)
Please enter your full name
Address / local contact details
City
State
Postcode
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Phone/Mobile (*)
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Email (*)
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Fax
Date of birth
Emergency contact details
For contact purposes only, please list your accommodation/contact details for the night prior to your hire
Can you swim?
Expected life-jacket size?
Medical information
Do you have any medical conditions that may potentially require treatment (including any joint problems)?





Other medical condition
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Please list any medications you are currently taking
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Kayaking experience
How much kayaking have you done? (*)
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What type of kayak do you have most experience in?
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How confidently can you re-enter a kayak after capsizing? (*)
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How confidently can you paddle in the following conditions?
Calm seas (<15 knots)
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Moderate seas (15 - 20 knots)
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Rough seas (20+ knots)
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Group size & names
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Proposed Itinerary
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Are you aware of the risks involved with kayaking in this location? For example, risks including (but in no way limited to)
Wind & Waves (strength, direction, sea breeze, surf, rips etc) (*)
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Risks to health (e.g. hypothermia, drowning, physical strains and exertion) (*)
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Type of kayak to hire (*)
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Departure Date
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Additional equipment required
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Would you like to receive information on special deals and new tours from Freycinet Adventures?
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Where did you first hear about these tours?
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I have read and understood the Conditions of Hire (*)
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I have read the Booking Terms and Conditions and Acceptance of Risk and accept them (*)
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