Thermalist Questionnaire | Wild Swim Adventures

First name

Last name

Email

Phone

Do you have any of the following?

If you have ticked any of the above boxes, please confirm that you have consulted a GP before participating in the Thermalist event and it is safe for you to do so.

Yes, subscribe me to your newsletter.

Multi choice

I understand that there are risks associated with Thermalist therapy and take full responsibility for disclosing any health conditions which may effect my participation

I am happy for Jurassic Coast Swimming to take and use images including videos for use on social media. If I am not ok with this I will speak to the organiser directly on the day

I declare the information is accurate and complete

Date

Day

Month

Year