Junior Term Renewal

Name D.O.B. Medical Conditions Training Commitment
Athlete 1 Yes No Tue Thur
Athlete 2 Yes No Tue Thur
Athlete 3 Yes No Tue Thur
Athlete 4 Yes No Tue Thur
Athlete 5 Yes No Tue Thur
Athlete 6 Yes No Tue Thur

Address (required)

Parent/Guardian Tel No (required)

Parent/Guardian Mob No (optonal)

Parent/Guardian eMail (required)

Athlete Mob No (optional)

Athelete eMail (optional)

Name of School currently attending (if applicable): for each relevant athlete -

Emergency Contact Details

Name of Contact

Relationship to Athlete

Emergency Contact No

Any Medical Condition (that you feel we should know about): for each relevant athlete -

Any Medication (that you feel we should know about): for each relevant athlete -

In the event of emergency treatment being required are there any restrictions that you wish to impose?: for each relevant athlete

Declaration

I understand that all coaches, volunteers and officials are vetted under the Child Protection Policy of Scottish Athletics. By submitting this form I consent to the following:-

I/my child agree(s) to abide by the Codes of Conduct and Ethics included in the Welcome Pack and as detailed on the Club website www.orkneyathleticclub.co.uk.I consider myself/my child to be physically fit and capable of full participation in this activity.I give permission for me/my child to take part in coaching sessions and events, including travel.I give permission for photographs/video to be taken of me/my child during sessions, to be used solely for the purpose of the Club, Club website, publicity or promotional purposes.I give permission for me/my child to receive First Aid treatment and care as deemed appropriate.


  

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