Call: (087) 810 6951
* Denotes a required field.
First Name *
Last Name *
School Name *
Number of Male Teachers *
Number of Female Group Teachers *
Number of Male Pupils *
Number of Female Pupils *
Average Age of Group Members *
Arrival Date *
Estimated Arrival Time *
Date To *
Estimated Departure Time *
Any Group Special Dietary Requirements We Should Be Aware of: (e.g. Allergies etc.) *
Any Group Medical History or Illnesses We Should Be Aware of: (Please Specify Medications etc.) *
Please Read The Following Information
Please forward on your deposit to the following address in the form of a personal cheque, bank draft or postal order in order to secure your booking (In the event of a late cancellation this deposit is non-refundable):
Lilliput Adventure Centre,
(044) 92 26789
(087) 810 6951 / (086) 810 6951
Do you agree to the above? *
At Lilliput Adventure Centre all of our instructors will endeavor to make sure that your group have a fantastic stay with us in a very safe, friendly and fun filled manner. However it is important for you as a leader to realise and be aware that their is an element of risk in all outdoor activities. During your stay here your group will encounter: heights, water, rough terrain, mud and situations that they may not be used to, depending on the weather. We would ask you as a parent or leader to make us aware of any medical conditions that may be of concern to us. We would especially be concerned about diabetes, epilepsy, anaphlaxia, brittle bone syndrome and asthma. You making us aware of these conditions will not prevent anybody from taking part in activities it will merely help our instructors to be more vigilant. We would also ask you to ensure that the people in your care bring the medications that they require.
Please read the terms and conditions below before sending the form:
I agree that on acceptance of this application that this group will under the guidance of our leaders co-operate with the rules and regulations as laid down by the staff and instructors of Lilliput Adventure Centre.
I also hereby agree to release Lilliput and or its representatives from any and all liabilities in respect of personal injury loss or damage, unless such injury loss or damage is the result of negligence on the part of Lilliput and or its representatives.
Do you agree to the above Terms & Conditions? *
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