Name(Required) First Last Email(Required) Addtional Travel Information; Please ensure that you complete this form and return to us as soon as possible. It contains important additional information which we require to complete your registration. Current Medical, health or Psyychologial conditions(Required)Cyurrent medication and it's purpose(Required)Special dietary requirements (e.g. vegetarian, gluten free)(Required)Specific learning aids(Required)Other information we should know about you regarding travel and accomodation(Required)Emergency Contact PersonName First Last Phone(Required)Relationship ImportantAfter booking your flights, please forward your flight details via email to rhonda@rexurwin.com so that we can arrange your airport transfers.Signature(Required)Date(Required) DD slash MM slash YYYY
