Trip consent form 2024

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This form is to provide trip leaders with the necessary information to run the trip safely and effectively. For children under 18, this must be filled in and signed by a parent/guardian.

Trip name *

Date
*

YYYY

Trip leader *

Name of participant *

Age if under 18

Mobile tel. no (Parent's no. if under 18) *

Emergency contact name *

Emergency contact tel. no *

Current medical conditions (please write 'none' if you have none) *

Are you currently taking any medication? If yes, please give details. *

Allergies (please write 'none' if you have none) *

I consent to medical treatment being provided to me/my child in the event of an emergency *

Yes

I have been informed of the difficulty level of the trip and am happy that I/my child demonstrate the required competence for the trip *

Yes

I agree to listen to the safety briefing given by the trip leader and clarify any points which are unclear. *

Yes

I acknowledge that canoeing can be of a strenuous and adventurous nature and accept the need for me/my child to behave responsibly and follow the direction of the trip leader. *

Yes

I understand that the club/trip leader accepts no responsibility for loss, damage or injury caused by or during attendance of the organised activity, except where such loss, damage or injury can be shown to result directly from the negligence of the club/trip leader. *

Yes

I consent to photos of me/my child taken during this trip to be published on the club website/Facebook page *

Yes

For parents/guardians of unaccompanied under 18s. Please write the name of the club member with whom you have made a personal arrangement to act in loco parentis for the duration of the trip. By signing this form you accept you have been informed of and are happy with the travel and sleeping arrangements for the trip.

Signed (Print name) Parents to sign for under 18s *

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