registration form

Name *

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Date of birth *

E-mail *

Emergency Contact (Name) *

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Phone Number *

Emergency Contact

Menu preferences: *

Please indicate if you are allergic or have a sensitivity to a certain food *

Please tick all that apply and give further info below where relevant

Do you have any medical conditions we should be aware of? *

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Do you have any physical limitations that may affect participation? *

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Are you currently taking any medications we should be aware of? *

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Please give more information on any relevant health conditions

What type of photography are you most interested in?

For example: Landscape, Portrait, Street Photography, Wildlife, Architectural

What would you like to experience during your journey?

Please tick the boxes below to confirm you have read this information and that you consent to what is described *

I take full responsibility for my own health and well-being during Nomia`s Photographers Journy.
I confirm that all the information given is true and correct. Nomia Experience will not be held responsible for any undisclosed information later be proved to have affected any services given.
I understand that I am responsible for having adequate travel insurance, and that Nomia Experience will not be held responsible for any damage or injury sustained during activities that take place outside of the event.
I agree that Nomia will use the photos I appear in, as long as they do not contain offensive or inappropriate content.
I confirm that I have read the Privacy Policy visible on the website, and Booking Terms & Conditions and agree to the practices described therein.
I understand that the online submission of this form replaces my signature and I consent to my health questionnaire being stored digitally on a password protected device.

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