Splash Week 2021

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Splash Week 2021

Please use this form to enter the event.

Parent/Guardian Name *

Mobile Number *

Postal Address *

Email Address *

Membership Number *

Participating Adults Information (if different)

First Child's Names *

First Child's DoB *

First Child's Membership Number *

First Child's Group Preference *

Second Child's Name

Second Child's DoB

Second Child's Membership Number

Second Child's Group Preference

Third Child's Name

Third Child's DoB

Third Child's Membership Number

Third Child's Group Preference

Fourth Child's Name

Fourth Child's DoB

Fourth Child's Membership Number

Fourth Child's Group Preference

Pre-Existing Medical Conditions

Asthma/Bronchitis

Heart Conditions

Fits, fainting or blackouts

Severe headaches

Diabetes

Travel sickness

Allergies to medication

Any other allergies

Other illnesses or disabilities

If YES to any of the above please elaborate below:

Are any of the Splashers taking medication? *

Yes

If YES please elaborate below:

Bringing an escort boat? *

Yes

If YES please elaborate below: *

Terms & Conditions *

I agree that the above information may be accessible to volunteers and employees working on behalf of the Royal Southern Yacht Club, and am happy to be contacted regarding this event and similar events in the future.

I confirm confirm that my child/children are in good health and that in the event of illness or accident; I consent to any necessary medical treatment which might include the use of anaesthetics.

I understand the Royal Southern Yacht Club is providing activities on the understanding that the club or its representatives bear no responsibility for any loss, damage, injury or inconvenience to vessels or persons howsoever arising directly or indirectly from their rules, policy or ruling during the activities.

I shall ensure that all boats brought to and used during Splash are sound and seaworthy and are covered by adequate Third-Party Indemnity for the duration of Splash

I have provided a suitable lifejacket for the weight of the child and it is correctly fitted.

I understand that photos may be taken of my child/children during Splash activities and published on the Royal Southern website and may be used in Royal Southern literature.

I understand that every child must have a responsible adult to accompany them during the entirety of Splash who should be able to participate in Splash fully.

Required

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