18+ VICTA Sport Social – Sailing at Cobnor Activities Centre

Apply for the 18+ Sailing Social 2026

Note for applicants completing this form
After completion, if you have successfully submitted the form, you should receive a successful submission message. If you do not it may be because you have not completed a required field. After your form has successfully gone through you will also receive notification via email. If you do not receive an email please contact the office on 01908 240 831 as there may have been a problem with your application.

Applicant details

First name *

Last name *

Age at time of activity *

Gender *

Male
Female
Other

If you have selected other, how do you currently describe yourself?

Confirmation of vision impairment

To qualify for this activity the lead applicant (your VI child) must be either registered or registerable as blind or partially sighted (sight impaired/severely sight impaired). VICTA will ask for supporting evidence post application if we have not previously received it.

Please confirm that the applicant is registered or registerable as Sight Impaired or Severely Sight Impaired *

Sight Impaired
Severely Sight Impaired

Do you have a guide dog? *

Yes
No

Contact details

Email *

Phone (please provide us with the most convenient number to contact the activity applicant on) *

Address 1 *

Address 2

City *

County *

Post code *

Independence skills

Please indicate your level of independence in the following areas by selecting your response and giving details if the assistance is required.

Your personal independence

Use of toilet *

Independently
With some assistance

If assistance is required please give details

Eating *

Independently
With some assistance

If assistance is required please give details

Mobility *

Independently
With some assistance

If assistance is required, please give details, what distances are manageable?

Please tick the box that describes your swimming ability: *

I can swim unaided (no arm bands/or parents) and over 25metres
I require arm bands/floating aids and can swim 10 metres or more
I need 1-2-1 support in the water

In order to ensure that activities are adequately staffed we need full and accurate information about all participants. Please note we reserve the right to refuse admission to the activity or ask a participant to leave the activity if the information given proves inaccurate or the conduct of the participant reaches an unacceptable level.

General information

The overall theme of this activity is about having fun, but we would like you to gain confidence and develop life skills through a programme of leisure, cultural and social activities. To help us plan our activities and staffing levels please describe your ability in the following areas:

Your social skills

Anything else we should know about you?

Your first language

Please indicate your preferred reading format/communication mode (e.g. print including font size) and give details of any specialist equipment and technology you use

Photographs and filming

Photographs and video footage may be taken during our activities. These will be used to create photo albums both on our website and on social media after the activity to share with family and friends and to celebrate the event, this may include your child’s name and age. VICTA may also use any photographs and/or video material taken during an event for marketing purposes, including being displayed on the VICTA website, on our social media channels, on charity emails and by connected third parties working in partnership with VICTA on this event/activity. Do we have your permission? *

Yes
No

Declaration, privacy and consent

To be signed by the applicant or a responsible person. This form has been completed accurately and I undertake to update VICTA should any of the information in this form change.
a. I agree to/for my child to take part in VICTA's activity and have read all the information sent to me.
b. I acknowledge the need to/for my child to behave responsibly at all times during the activity.
c. I confirm that this form has been completed accurately and I undertake to update VICTA's organisers should any information contained on the form or personal circumstances change.
d. In the event of an emergency/accident, I consent to emergency medical treatment, which may include the use of anaesthetics.
e. In order to ensure that activities are adequately staffed we need full and accurate information about all participants. Please note we reserve the right to refuse admission to the activity or ask a participant to leave the activity if the information given proves inaccurate or the conduct of the participant reaches an unacceptable level.
f. Whatsapp is a great tool that can be used to communicate activity information and help facilitate social interactions. From time to time, VICTA facilitates Whatsapp groups for 18+ participants who have given consent to do so to get to know one another before an activity. While VICTA facilitates these opportunities, they are not monitored and therefore your behaviour and language used on Whatsapp must match the expectations we have of you when we meet in person – polite, courteous, and inclusive at all times. If you have any questions surrounding this, please contact the Activities Team on activities@victa.org.uk
g. By signing this form you consent to VICTA using the information supplied for the purpose of administering the named event. All the information will be treated in the strictest of confidence and made available only to those staff working with the participant. We may need to share your details with third party suppliers in relation to this activity. Contact information will be retained and used for marketing of other relevant services.
h. I give consent for VICTA to carry out the following in accordance with the UK General Data Protection Regulations as supplemented by the Data Protection Act 2018 and related laws and to store my personal information on VICTA's database and/or any other suitable system.

Agreement to declaration *

I agree
I do not agree

Applicants must be aged 18 to 29 years *

I confirm that the applicant will be 18 to 29 years old at the time of this activity

Signed (insert name) *

Date *

My relationship to the applicant (if applicable)

Parent
Legal guardian
Other

If 'other' please state

Would you like to be added to a WhatsApp group for this social? *

Yes
No

Would you like to sign up for email updates from VICTA to hear about future activities? *

Yes please
No thank you
I'm already signed up

This summer, set sail with VICTA Sport for our latest 18+ sport social event.

Meet VICTA Changemaker Zehra!

Apply below