Parent’s Details

Additional Emergency Contact

Name

Medical Information

Does the child have a disability the course leader should be aware of ? NoYes

Does the child have any medical conditions, take any medication or undergoing any current medical treatment that could limit or affect their involvement in the activity ?NoYes

Is the child allergic to any medication ?NoYes

Consent

I give my consent for the child named above to take part in water and land-based activities provided by Wargrave Boating Club.

I understand the activities provided by Wargrave Boating Club are of an adventurous nature. I acknowledge that adventurous activities carry an element of risk and therefore accept the need for responsible behaviour, including listening to and following safety instructions.

I have declared all relevant medical conditions in the Medical Information section of this form.

I have read the Information of Weil's Disease.

In the event of an emergency I agree to the child receiving any medical treatment, including anaesthetic, as considered necessary by the medical authorities.

I understand that my child needs to have passed the Wargrave Boating Club Swim Test to be able to take part in the kayaking, punting, skiffing and SUP courses.

I will provide a well-fitting buoyancy aid for the child for kayaking and SUP courses and also for the dinghy course if they’ve not passed the swim test.

I understand it is my responsibility to ensure the child is collected at the stated time.

Please tick if you are happy for your child to leave without an adult accompanying (Y7+ only).

Submit