Port Edgar Watersports CIC Activity Consent Form - young and vulnerable persons
By submitting this form you agree to the following:
- The activities provided by Port Edgar Watersports CIC are sometimes of a strenuous and adventurous nature that carry a level of risk to participants. I acknowledge and accept that adventurous activities carry an element of risk.
- I have declared all the participant's relevant medical conditions in the Medical Information section of this form. I declare that the participant is confident in open water whilst wearing a buoyancy aid or lifejacket.
- In the event of an emergency I agree to Port Edgar Watersports CIC or their representative contacting the emergency services on the participant's behalf. I agree that the emergency services may then take responsibility for the participant's care.
- I have read and understood all the information provided in the Booking Terms and Conditions, and read and understood the pre-course information.
- I consent to the use by Port Edgar Watersports CIC of photographs or film made of the participant during the activity, for any legitimate purpose.
- I consent to my contact details being added to the Port Edgar Watersports database, which will be used for marketing purposes.

If you do not wish the participant's image to be used, or if you wish to opt out of marketing communications, please inform the office via bookings@portedgarwatersports.com. If you wish your completed form to be deleted after your course please inform the office.

Please note a form must be completed for each participant.

Participant details
First name
Your answer
Surname
Your answer
Gender
First name of person completing the form (this must be the participant's legal guardian or carer)
Your answer
Surname of person completing the form
Your answer
Email address
Your answer
Phone number
Your answer
Home address
Your answer
Postcode
Your answer
Emergency Contact details
Name
Your answer
Relationship to participant
Your answer
Phone number
Your answer
Medical information
Would the participant be considered to have a disability?
If yes please give details
Your answer
Does the participant have any medical conditions that might affect their participation in our activities?
If yes please give details, including current medication
Your answer
Where did you hear about us?
Date form completed
MM
/
DD
/
YYYY
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