Cobra Sports Services - SEQ Training Application
SEQ Training Application Form - UAE
  • Data
Data
DATA
Applicant Name *
Personal Photo *
  • File
Gender *
Date of Birth *
Nationality *
ID Number *
Emirates ID (for residents) or Passport No. (for visitors)
ID Issue Date *
ID Expiry Date *
Applicant Mobile *
For example, 971-50-111-1111
Applicant Email
Emergency Name *
Emergency Mobile *
For example, 971-50-111-1111
Applicant Type *
Training Level *
L1 Certificate Number
In case the applicant passed SEQ Level 1 earlier.
L2 Certificate Number
In case the applicant passed SEQ Level 2 earlier.
Does the applicant require any special arrangements during the course? *
Special Arrangement Details (if required)
Are you at age below 18? *
If the applicant is under 18 years of age, the parents must sign the application on-behalf of the applicant.
I, undersigned, declares that I am fully compliant with the following; *
Consent: During the course opportunities may arise where photos or videos are taken. These can be used as educational tools or for social media posts. Please sign below if you are happy to give consent to your image being used.
Please specify any medical advise given to you
Please list all medical conditions that we should be aware of
Do you have any known allergies? please specify
For women, are you pregnant? if yes, risk assessment to be identified
Do you have impairment? Please specify
Please specify how the tutor can help you during the course;
English Proficiency Level: *
Although it isn't mandatory to know swimming, you will be in water, are you water competent? *
By signing this document you (the learner) are agreeing that *
You are fit & healthy to continue with your learning programme. You agree to take responsibility for any medical issues that may arise as a result of the medical information declared above.