2021 consent and medical form
Sign in to Google to save your progress. Learn more
Swimmer full name *
Swimmer date of birth *
MM
/
DD
/
YYYY
Emergency contact 1 name *
Emergency contact 1 number *
Emergency contact 2 name *
Emergency contact 2 number *
Personal and medical details
Please provide any information regarding the health and well-being of the swimmer that is not already known to the club.
If there have been any changes in personal details that are not known to the club, including changes in address, phone number and GP information, please provide them here.
Parental consent
I give parental consent for my child to participate in Edinburgh Synchro training, competitions and training camps in 2021.

I agree to respect the decisions of the coaches and team managers whilst my child is on an Edinburgh Synchro activity.

I accept the club's selection process, as outlined in the Coaching Philosophy and Selection Process 2021 document (http://edinburghsynchro.co.uk/club-governance/).

I understand the need for exemplary behaviour, as per the swimmer code of conduct, on the part of my child when representing the club. I give assurances that my child will treat all members of the party and public with respect. My child understands the need to listen to, and respond to, coach and team manager instructions.

I will inform the club as soon as possible of any changes in the medical or other circumstances of my child, including emergency contact details.

I am aware that any valuables brought by my child will be at their own risk.

I agree that if I confirm that my child will attend an event I will pay the full fee even if my child does not attend, for whatever the reason.

I have read and understood the club's 2021 Privacy Notice (http://edinburghsynchro.co.uk/privacy-notice/).

In the event of illness, I give permission that my child can be given medical treatment, including ibuprofen/paracetamol, where considered necessary by a trained First Aid person, or by a suitable qualified medical practitioner. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency dental,, medical or surgical treatment or medication, including anesthetic or blood transfusion.

I agree to the above *
I give / do not give permission to Edinburgh Synchro to take photos and videos of my child for the use of Edinburgh Synchro and Scottish Swimming, including putting them on the internet, social media and in promotional material. *
Signature *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy