RYA Student Information Form Please enable JavaScript in your browser to complete this form.RYA Student Information FormPlease fill in the details below to complete your registration for your RYA course with Tasman Adventures!Course *Competent Crew (No pre-course experience needed)Day Skipper (Must have 5 days, 100 miles & 4 night hours)Coastal Skipper (Must have 15 days, 2 days as skipper, 300 miles, 8 night hours)Do you have the minimum experience needed for this course? *I can confirm I have the minimum experience needed for my course!Date course starts *Name *FirstLastDate of Birth *We're not interested in your age, this is just a unique identifier for our records!Email *EmailConfirm EmailAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodePhone *Next of Kin DetailsNext of Kin NameWho should we contact in case of emergencies? Please make sure this person is not on the course with you.Phone numberAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryHealth DeclarationAlthough illness or medical conditions should not prevent you from taking part in this course, we must be aware of any issues that we may need to help you overcome. If you are in any doubt about your fitness to take part in this course, your GP should be able to advise you further.Please give details of any medical condition or current treatments *Please type "Nothing" if you have nothing to tell us!If you suffer from epilepsy, giddy spells, asthma, diabetes, heart condition or anything else you think may affect you during your course, please provide details below:Medical Declaration *I have read and understood the above statements and declare that to the best of my knowledge I am fit to participate in the course!About YouSailing/Sea ExperienceLet us know a little about your background so that we can tailor the course to your experience!I confirm that I meet the prerequisites in terms of experience and any certification required for this course. *I confirm that I meet the course entry requirementsMarket researchHow did you hear about Tasman Adventures?Web searchWeb advertisementOther advertisementRecommendation/referralOtherPhoto permissionsI grant to Tasman Adventures, its representatives and employees the right to take photographs of me in connection with Tasman Adventures courses and programs. I authorize Tasman Adventures to copyright, use and publish the same in print and/or electronically.You can take pictures of me and use themI agree that Tasman Adventures may use such photographs of me with my name and for any lawful purpose, including such purposes as publicity, illustration, advertising and Web content.You can use my name with picturesThe above information including the questions as to your health and ability will be used by us to process your booking for the course and for attending to your safety whilst you are on our courses. Names and addresses of candidates for RYA and AS courses will be shared with those entities for the purposes of registering your certificate. This data will not be shared with any third party for marketing or commercial purposes without first obtaining your explicit consent. *I have read and understand the above statement.EmailSubmit Form