Medical Form

All sections of this form must be completed by the participant or a parent/guardian (if under 16) prior to participation. You must also inform us of any changes to this form prior to participation.

Name of parent/guardian

Name of Participant

Thanks for submitting! We look forward to welcoming you

at The ARC Centre soon!

Thanks for submitting! We look forward to welcoming you

at The ARC Centre soon!

Thanks for submitting! We look forward to welcoming you

at The ARC Centre soon!

Thanks for submitting! We look forward to welcoming you

at The ARC Centre soon!

Thanks for submitting! We look forward to welcoming you

at The ARC Centre soon!

Thanks for submitting! We look forward to welcoming you

at The ARC Centre soon!

Email Address

Participant date of birth

Emergency contact number 1

Emergency contact number 2

Name of class/event attending:

Any relevant information (e.g. asthma, allergies, medication, additional needs or current injuries etc)

Yes

If you answered yes, please give us additional information.

Please note, The ARC Centre can only oversee or administer the taking of medication by children if the medication is clearly marked with the child’s name and we have received a completed Medication Consent form from the parent/guardian which states dose and time. Consent is required even if the child is able to self medicate (e.g. asthma inhaler).

Please contact us to discuss any medication needs prior to the event.

In case of emergency, The ARC Centre reserves the right to seek emergency medical care for any child under their direct care and supervision, until the parents/guardians can be contacted.

GP's contact details

GP's Phone Number

Animal handling permission.

Our sessions do include animal handling. We request your permission for your child to partake in this, whilst understanding that The ARC Centre cannot be held responsible for any animal related injuries that occur whilst handling or observing.

Please confirm your animal handling consent:

Yes

Photo/Video permission.

Please confirm your consent to take photos/videos of yourself/your child:

Yes

Please confirm your consent to use these in promotional materials:

Yes

Sun cream.

We advise all children to bring suitable sun cream with them if the weather is suitable, but in the unlikely event this has been forgotten, we have a small supply on site which your child may self-administer.

Please confirm your consent for suncream:

Yes

Permission for further classes and camps:

If you would like to, we can use this medical form for all future activities. Please be advised that if you give us this permission, it is your responsibility to update us on any changes to this form.

Please confirm your consent for further classes and camps:

Yes

Initials

I accept terms & conditions

Today's Date

I declare that the info I’ve provided is accurate & complete

Please note, we store these forms whilst your child is enrolled on one of our classes. If you give permission for us to use this form for further classes and camps, we store this form for up to year after the last booking. We use your email to contact you with regards to classes and activities at the ARC. We use your phone number solely to contact in emergencies or specifically about your child. We never pass your details onto third parties without having previously discussed and agreed with you. If you have any queries on how we store and use your data, please contact us.