The crew at Windswell are committed to ensuring everyone who joins them for an adventure of a lifetime does so with the peace of mind that your health and safety is our top priority. To help us achieve this, please fill out the Health & Safety Declaration on the form below.

Your activity
- SUP
- Reef Tour
- Intro Kite
- Kitesurf Lessons
- Wakeboard, Foilboard or Tube ride
- Demo Hire
Your Name*
First Name Last Name
Date of Birth*
Address*
Street Address City State / Province / Region Country
Email*
Phone*
Emergency Contact*
Emergency Contact Phone Number*
Can you swim 200 metres?*
Can you tread water for five minutes?*
Are you aware that deadly marine jellyfish or saltwater crocs can sometimes inhabit these waters?*
WindSwell asks your permission to take hero shots of you and can use them for marketing purposes and we retain copyright*
Do you have, or have you received treatment for any of the following?
Lung or other breathing / respiratory disorder*
eg: Asthma / Wheezing
- No
- Yes
Heart, blood vessel or other blood circulation disorder*
eg: Heart attack / Chest pain / High blood pressure / Abnormal heart rhythm / Bleeding or blood clotting disorder /
- No
- Yes
Brain, neurological or other nerve pathway disorder*
eg: Epilepsy / Blackout / Fainting attacks / Stoke /
- No
- Yes
Other condition*
eg: Diabetes / Abnormal blood sugar levels
- No
- Yes
Do you wear corrective lenses?*
Do you have hearing difficulties?*
Do you take regular medication by mouth, inhalation or injection?*
Please provide details of medication
I hereby waiver all and any claim, as permitted by statute or law, arising out of injury, damage, or loss of any description whatsoever, which I may suffer or sustain whilst using the marine park and council reserve areas and upon my entry or participation in any lesson conducted by WindSwell Kites Surfing and Stand Up Paddling*
I agree
Payment method
- cash
- online
- credit card
- voucher
- bank transfer
Comments
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Health & Safety

Health & Safety declaration

Do you have, or have you received treatment for any of the following?