Venture Out Expeditions - DofE Participant enrollment form.
This form must be completed to book your place on a School Expedition. This form will be shared with any supervisors, assessors that are involved in your expedition. For participants under 18 years of age a parent, or person with parental responsibility, must complete the form.

Participant's First Name *
Your answer
Participant's last name *
Your answer
Date of Birth *
Your answer
Gender
Address: House Number and Street Name *
Your answer
Address: Area
Your answer
Address: Town/City
Your answer
Address: Postcode *
Your answer
Participant's email address *
Your answer
Participant's mobile number *
Required in case of emergencies
Your answer
Parent/Guardian Name *
This should be a parent or Guardian that can be contacted day or night in an emergency, and someone that can be contacted directly regarding this booking information
Your answer
Parent or Guardian: email address *
Your answer
Address *
Your answer
Daytime telephone number *
Your answer
Night time telephone number *
Your answer
Emergency Contact: mobile telephone number *
Your answer
Medical and Personal information
It is important that all relevant information is disclosed here to allow us to properly support and care for your child. If you have any concerns please contact the Duke of Edinburgh Manager at your Centre
Details of any medical conditions
e.g. asthma, diabetes, epilepsy.Or recent medical treatments.N.B. If a condition is declared, a doctor must be consulted about participation in this strenuous activity. See Parent Booklet for more details.
Your answer
Details of any medication currently being taken, dosage and how of it is taken.
If regular medication is needed please ensure that sufficient is provided to last through the expedition.
Your answer
Name of Participant's Doctor *
Your answer
Doctor's address *
Your answer
Doctor's telephone number *
Your answer
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