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ACTIVITIES AWAY

ACTIVITY CONSENT & MEDICAL CONSENT FORM
17Questions
  • 1

    When we ask for YOUR NAME - please complete this if you are the PARTICIPANT OR if you are the PARENT of a CHILD PARTICIPANT.

    If it is your CHILD or CHILDREN who are attending you will be asked to enter their names on later pages.

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    • Wings School Notts
    • Glentworth Brownies/Guides
    • Lincoln Evangelical Church
    • The Meadows YR 5
    • The Meadows YR 6
    • St Georges - Sleaford (Monday 8th July)
    • St Georges - Ruskington
    • St Georges - Sleaford (Wednesday 10th July)
    • St Faiths, St Michaels
    • St Michaels
    • 6th Scunthorpe Scouts
    • 1st North Hykeham Guides
    • Skellingthorpe Scouts
    • 2nd Lincoln Club Scouts
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  • 3
    This is your name if you are the participant or parent a participant u16
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  • 4
    Please enter an email address if you want a confirmation email on completion
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  • 5
    Only required if your child is the participant
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  • 6
    This is for any second child attending
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    This is for any third child attending
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  • 8
    Please enter your emergency contact number here
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  • 9
    Please enter the NEXT OF KIN NAME details here
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  • 10
    If completing for a child please state their NAME after the condition.
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  • 11
    If completing for a child please state their NAME after the medication
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  • 12
    If completing for a child please state their NAME after the injury
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    If completing for a child please state their NAME after the allergy
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  • 14
    Please include any special needs, disabilities or religious requirements
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    THIS IS THE LAST PAGE!

    PLEASE READ THE FOLLOWING STATEMENT & SIGN ON THE NEXT PAGE

    Acknowledgement of risk

    Steven Poulton trading as ACTIVITIES AWAY and MARINE MASTERS ask that you read and sign the next page to acknowledge you have read these terms of participation prior to attending for your activity event.

    SAFETY STATEMENT

    There will always be some real risk involved in the activities we offer.

    This residual risk is inherent in the activities and can not be totally eliminated without destroying the activity, or the reason for doing it.

    However, the risk is generally confined to a similar level that a normal child involved in normal active play may experience, or a normal adult involved in normal active recreation would experience.

    The overall level of risk is low.

    We believe it is a tolerable risk when compared to the benefits.

    However, you must decide if you also consider it tolerable.

    To help you do this you will be given a full safety brief on the day of your event prior to activities commencing and individual activities will be explained to you at the relevant time.

    All activities are carried out under instruction and extensive risk assessments and safety procedures are in place.

    Civil and criminal law requires that we take all reasonable care of you.

    We believe we do more than the law requires, but certain inherent risks may still remain which we can not remove without destroying the nature of the activity.

    Our aim is to reduce risks to the lowest tolerable level consistent with the nature and ethos of the activity.

    This document is not a ‘Disclaimer’ and by signing this document you will not lose ANY of the rights due to you as a participant.

    The aim of this document is to inform participants (or their parents) so they can make a more informed choice about participation.

    We operate a PARTICIPATION BY CHOICE policy which means that if you are unsure or not happy to participate in any or all of the activities on the day, then you will be able to forfeit your go and if the event is a team challenge or team building activity, no points will be deducted from your team.

    Please read the following declaration as you will be asked to sign to say you have read it on the next page and explained the need to follwo our instructors instructions to your child -

    I understand that all outdoor activities are ‘Assumed risk’ sports that carry attendant risks.

    I am aware of and accept these risks and will be responsible for my own action and involvement and accept these on behalf of my child if applicable.

    I will ensure I (or my child) will declare all relevant information to the instructors and will follow their directions and instruction at all times.

     

     

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