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Is your child now receiving medical treatment from your family doctor or hospital and/or has he been given specific advice to follow in emergencies?

If Yes to any of the above Medical sections please give fuller details (e.g. type of allergies, medical treatment, etc). If helpful please send us medical documents.

If applicable, please outline any specific DIETARY requirements for your child.

Is your child currently vaccinated against TETANUS ?

PLEASE NOTE In accordance with the General Data Protection Regulations, Greygarth only keeps member details for health and safety needs while with us, and for maintaining records of membership and support for the club. This information will be used solely for these purposes. Please contact warden@greygarth.org.uk ; if you want to know what data we hold about you, or to have it removed or updated.

I confirm that my child is able to swim and consequently I am happy for him to participate in activities involving water.

Yes No

I consent to Photographs of the above being used in Greygarth Boysclub literature or websites, on the understanding that they will not be accompanied by any personal details which may identify the child.

Yes No

I agree to my son receiving medical treatment including anaesthetic as considered necessary by medical authorities present. I also agree to my son receiving basic First Aid by members of staff present.

I agree I do not agree

I agree to my son taking part in any or all Greygarth activities as proposed unless I say otherwise in writing. I have ensured that my child understands that it is most important for his safety and the safety of the group that rules and instructions given by staff in charge are obeyed. I understand that while the leaders in charge of the group will take all reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by the child which may occur as a result of the activity.

I agree I do not agree

Greygarth Boysclub Membership & Medical Consent Form

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