Online - Parent / Guardian - Consent Form / Parental Consent Forms

Parent / Guardian - Consent Form

Name *

Date of Birth *

Age *

Address *

Contact Telephone number *

Post code *

Email address

Medical information - Any specific medical conditions requiring medical treatment and/or medication? [ If Yes please give details ] *

Yes
No

Details

Any allergies? [ If Yes please give details ] *

Yes
No

Allergy details

Doctors *

Doctors/ telephone number *

Contact Telephone number in case of emergency *

Name and relationship *

Parent / Guardian *

I, being parent/guardian of the above named child hereby give permission for the Team Manager to give the immediately necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son/daughter's interest, in the doctor's medical opinion, for any delay to be incurred by seeking my personal consent.

Code of conduct *

I have read the Code of Conduct and agree that my child should abide by this whilst in the care of the club and I understand that a serious or continued breach of this code may result in my child being sent home early at my expense.

Parental Consent

Parental Consent (to be signed for competitors under 18 years) I confirm that I have received the details of the above activity and consent to my child taking part in the visits and activities indicated. *
I acknowledge that the club will be liable in the event of any accident only if they have failed to take reasonable steps in their duty of care for my child during the trip. I understand that the staff has a common law duty to act in the capacity of a reasonably prudent parent.

Name of ( Consenting parent / guardian ) *

Date *

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Parent / Guardian - Consent Form

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