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Junior/Vulnerable Consent form (Online)

Junior/Vulnerable Adults Consent Form

Junior/Vulnerable Adults Consent Form - CONFIDENTIAL

This form must be submitted by Parents /Carers with membership applications for Junior(under 18s) or Vulnerable Adults

DETAILS OF APPLICANT

Name of young person or vulnerable adult *

Address *

Date of Birth *

Home Phone

Mobile Phone

Email Address

In the interest of your child/vulnerable adult, it is important to know whether he/she suffers from any illness or medical condition. Please use this space below to state, in confidence, any health or other matter concerning your child/vulnerable adult of which our Club Officials should be aware. Please also indicate any prescribed medication etc. *

I consent to my child/vulnerable adult, named overleaf, whilst accompanied by his/her parent, carer or responsible adult, taking part in the Club activities on its premises. I acknowledge that the Club will take all reasonable steps in the exercise of their duty of care to him/her from accident or any other harm, but the overall safety and behaviour of juniors is the full responsibility of the parent/carer.

In the event of any photographs being taken at the Club, I give my consent for the above-named junior/vulnerable adult to be allowed to be included. The photograph(s) may be used for display around the Clubhouse, in advertisements for the Club on posters and advertising materials for publicity purposes, and on our official Club website. If you are not happy to allow this, please place a tick in the box *

I am not happy with this.

All information given on this form will be respected as being confidential to Ipplepen Bowling Club and will be held on file for the duration of the young person’s membership, and to this I give my consent.

Signed: (Parent/Carer) *

Name of Parent/Carer *

Address, if different *

Relationship *

Home Phone

Mobile Phone

If you require any information about Club activities, or have any concerns regarding your child’s/vulnerable adult's participation, please contact Mrs. Mary Oliphant, our Coach and Safeguarding Officer. Telephone: 01803 872683 or email: oliphant966@btinternet.com