Parent/Guardian Medical & Consent 2023

Parental/Guardian Medical & Consent Form 2023

For Junior/Youth Training, Club Racing and Open Events e.g. Wayfarer Nationals, Mersea Week This form is not applicable to Sunset Series, EA Beasties Tour or Cadet Week when parents/guardians are required to volunteer and/or complete a dedicated Registration or Entry Form.

Section One

Contact Details and Medical Information

Child's Name(Required)

Is child a Member of Dabchicks Sailing Club(Required)

Yes

Child's Date of Birth(Required)

Contact Phone No:(Required)

Email(Required)

Child's Address(Required)

Medical Information

It is your responsibility to inform the Dabchicks Sailing Club of any known or potential medical conditions that may affect the above during the activities/events associated with any training or racing programme or event you are taking part in.

Please therefore provide as many details as possible. This information will be shared with key organisers and coaches at training and events.

Medical Part 1(Required)

Yes

Does the named person suffer from or have any medical condition that the Club need to be made aware of?

Please provide details of Medical Conditions(Required)

Medical Part 2(Required)

Yes

Is the named person currently taking any medication, or have any food allergies or have dietary requirements?

Please provide details of medication, food allergies or dietary requirements(Required)

Emergency Contacts

Name of Next of Kin(Required)

Relationship to Child(Required)

Mobile Number(Required)

Section Two

Risk Assessment

RISK STATEMENT It should be recognised that sailing is by its nature an unpredictable sport and therefore inherently involves an element of risk. By taking park in the sessions you agree and acknowledge that:

You and your child are aware of the inherent element of risk involved in the sport and you accept responsibility exposing yourself to such inherent risk whilst taking part in the session;
You and your child will comply at all times with the instructions of the OOD and / or instructors, particularly with regard to handling of boats, wearing of buoyancy aids and the wearing of suitable clothing for the conditions;
You and your child accept responsibility for any injury, damage or loss to the extent caused by your own negligence;
You and your child will not participate in the session whilst your ability to skipper or crew a dinghy is impaired by alcohol, drugs or whilst otherwise unfit to participate;
The provision of patrol boat cover is limited to such assistance, as can be practically provided in the circumstances;
You and your child are aware of any specific risks drawn to your attention by the Open Day OOD / instructor;
You and your child understand that the Club provides rescue facilities, supervision and control only during the sessions.
The minimum age for taking part in a training course is 8 years old.
CLOTHING I undertake to ensure that he/ she will attend the Dabchicks sailing club activities suitably clothed.
WATER CONFIDENCE I declare that the above named is water confident.

CANCELLATION

You understand that the Club may cancel or postpone any session at any stage in the event of bad weather, equipment failure or otherwise.

MISCONDUCT

You understand that the Club may exclude anyone from a particular session and evict anyone from the premises.

PHOTOGRAPHY

I understand and agree that my child may be photographed or filmed by the Club or its agents and the images used for promotional or training purposes and waive any copyright.

DATA DECLARATION

I understand that the Organising Authority will hold and use our personal data for the purpose of the event. Further information can be found in the Club’s privacy statement

Name(Required)

Signature(Required)

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