Forms

First name of participant*:

Surname of participant*:

Participants date of birth*:

Participants level of sight*:

Details of sight condition if known:

How would you best describe the participants gender?*

Which best describes the participants ethnicity.*

Other Ethnic Group

In addition to a visual impairment, does the participant have any other disabilities or medical conditions you feel the organisers need to be aware of?

Will the participant be bringing a guide dog to the event?*

Yes No

Is the participant a current BBS member*:

If you have a friend attending the event that you wish to be put in the same group as please let us know their name below.

How did you hear about this event?

Other

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Glasgow Senior Have A Go Day

Participant Details