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Medical and Consent Form
U18 attending programmes or sessions on site
First Name (*)
You must provide your name
Surname (*)
Your must provide your surname
Programme Reference (*)
You must input the programme reference code
Select your programme start date (*)
You must select the date from the calendar
Are you attending with your school,college or an organisation? (*)
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Enter the name of your school, college or organisation
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Contact Email (*)
You must provide a valid email address
Home Phone
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Mobile Contact No
Please write a subject for your message.
Address Line 1 (*)
You must provide an address
Address Line 2
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County (*)
You must provide your county
Postcode (*)
You must provide your postcode
   
It is vital that we are aware of all existing medical issues or medical conditions/illnesses/allergic reactions that the young person may have (e.g. food allergy – please specify foods, asthma, heart conditions, pregnancy, back problems) and any medication that is used to control these conditions (e.g. inhaler, adrenalin etc): If the young person has an existing medical condition, we recommend that you take advice from their GP to establish what sort of activity it is safe for the young person to take part in on their programme. To minimise the risk of picking up insect bites in the outdoors environment we recommend the young person wears long trousers and stout footwear. This is good practice in countryside areas. Please refer to our suggested kit lists.
Does the young person have any existing medical conditions?
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Please provide details of any existing medical conditions and any current medications
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Next of Kin (*)
You must provide the name of your next of kin
Doctor's Name (*)
You must provide your doctor's name
Doctor's Phone (*)
You must provide your doctor's telephone number
Relationship to next of kin (*)
You must state the relationship to your next of kin
Kin Home Phone (*)
You must provide a telephone contact number for your next of kin
Kin Mobile Number
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Provided that we are given at least three working days notice we can normally cater for special dietary requirements eg vegetarian, vegan or any allergies. To allow for food preferences our standard menus offer plenty of choice.
Does the young person require a special diet? (*)
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Please provide details of special dietary requirements
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I have read, understood and correctly completed this form. I have declared all of the existing dietary and medical conditions of the young person. I agree that the young person will not take part in any activity that I know may aggravate an existing medical condition that they have. I understand that the young person is responsible for their personal belongings whilst on their programme. I understand that the young person must be a responsible participant on the programme. I agree that any photographs or digital images taken at The New Forest Outdoor Centre may be used by the New Forest Outdoor Centre for publicity purposes. I understand that the New Forest Outdoor Centre may use my email address to send me information about the programme or session the young person has attended. I understand that these details will NOT be passed on to any other companies or parties. I declare that I am aware that outdoor activities carry a certain element of risk and that I understand those risks and accept them as part of the activities enjoyment for the young person.
Check to confirm (*)
You must check the box to confirm that you have read and understood the form
Name of parent or guardian (*)
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Prove you are human(*)
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