Email address *
JUNIOR MEDICAL AND PARENT CONSENT FORM
1. Name of the Junior member *
Your answer
2a. Date of Birth *
Your answer
2b. Is the junior member a British National? (required for Volleyball England Talent pathway or subsidies)? *
Required
3. Name of current school/ college: *
Your answer
4a. Parent/ Carer's Name: *
Your answer
4b. Relationship to the junior member: *
Your answer
5a. Parent/ Carer's Mobile number: *
Your answer
5b. Junior member's number if you would like us to keep it in the 2019-20 club register:
Your answer
5c. Home number:
Your answer
6. Please confirm Parent/ Carer's Email: *
Your answer
7. Address: *
Your answer
8. Emergency Contact Name: *
Your answer
9. Emergency Contact Number: *
Your answer
10. Member's medical information - any important medical conditions that the club should be aware of? (eg. epilepsy, asthma, diabetes...etc or None if not applicable): *
Your answer
11. You give permission to use any still and / or moving images being video footage, photograph of the named junior member above for any of the following uses (please check all that applies) *
Required
Comments:
Your answer
Declaration
By submitting this form, you, the parent(s)/guardian(s) of the named junior member have read and understood the Cambridge Volleyball Club Code of Conduct and Young Person's Guide stated BELOW. In the event of an injury you give permission for the club to obtain emergency medical treatment.

You understand the changing facilities at training / match venues may be shared by other adult and junior members or members of the public; your child may change or shower at home should they be uncomfortable in using the facilities provided.

You also understand and hereby waive all claims for damages or loss to the named junior member and property as a result of accidents sustained with or in relation to Cambridge Volleyball Club, and the named junior member will comply with the section specified in "What does my club expect of me?"
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