Emergency Contact Form - On The Ball Coaching
Details on this form will be held securely and will only be shared with coaches or others who need this information in order to meet the specific needs of the student in the lesson.
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Name of student (first + surname) *
Date of Birth (e.g. 01/01/2015) *
Name of Tennis Club attending (e.g. Woodthorpe, Southwell) *
Day + Time of lesson (e.g. Tuesday 4pm) *
Primary emergency contact - Name (first + surname) *
Relationship to student *
Contact number *
Email *
Secondary emergency contact - Name (first + surname) *
Relationship to student *
Contact number *
Email *
It may be essential for the responsible adult accompanying your child to have the necessary authority to obtain any urgent treatment which may be required. Please confirm that you give your consent. *
I, ________________________________ being the parent/carer of the above named child hereby give permission for the responsible adult to give the immediately necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son/daughter’s interest, in the doctor’s medical opinion, for any delay to be incurred by seeking my personal consent. (Please write the name of the person giving consent below). *
Photo consent: We will not permit photographs, video or other images of children (anyone under 18) to be taken without the consent of the child and their parent or carer. *
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