Registration/Consent
Scout's Name *
Group / Troop *
Home Address *
post code *
Phone *
Email *
DoB *
MM
/
DD
/
YYYY
National Health No
Date of last Tetanus
MM
/
DD
/
YYYY
Any Medical or Educational conditions that course leaders should be aware of, e.g. asthma, allergies, or recent hospital admissions, special educational needs, etc (Cuts must be covered with waterproof plasters)
Ability to swim 50 metres *
Required
State previous sailing experience/courses attended *
Emergency Telephone Contact Person *
I have noted the arrangements and give permission for the above named to participate in the sailing activity arranged. If it becomes necessary for my child to receive medical treatment and I cannot be contacted by telephone or any other means to authorise this, I hereby give my general consent to any necessary medical treatment and authorise the Leader-in-Charge to sign any document required by the hospital authorities *
Required
Please print Name in caps *
Date *
MM
/
DD
/
YYYY
Submit
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