Travel form 2022/2023

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As per the requirements of the University the data required in this form will be held on file by the AUC and the SIRC Office as a record of the respective club trip. In the event of an incident / accident on the trip, the data will be used by the AUC and SIRC Office to contact the trip leader and members travelling/next of kin, where appropriate. The data submitted will also be used to verify that the club is compliant with the Safeguarding Policies of the AUC and the University.

Email *

Club Name *

Dates Travelling *

YYYY

Reason for Trip: i.e competition, training, social etc? *

Location where activity is taking place? *

Name and contact number of person responsible for organising the trip (trip organiser) *

Name and contact number of person in charge of the group while away (trip leader) *

Statement: I can confirm that the trip leader holds a valid Safeguarding 1 certificate, has been through the Garda Vetting process and is permitted by UCD AUC to lead this activity. *

Yes

Required

Please confirm which leader will be responsible for the management of any suspected Covid-19 cases while on the trip (Name, Phone Number) *

Name and type of accommodation venue being used: *

Please confirm Club's accommodation arrangements while away i.e. numbers in rooms, houses and how decided *

Please confirm how many members have been assigned or are sharing each room in this accommodation. *

In case of emergency, name and location of the nearest hospital *

Number of people travelling *

Method of travel to the venue *

Private cars

Hired bus

Train

Other:

Names, student/graduate/staff numbers and mobile numbers of those travelling *

Are you aware of any person travelling who has a pre existing medical condition or receives mental health treatment? *

Yes

Required

If you have ticked 'Yes' to the question above, please confirm that you have access to emergency contact details for the person and where applicable, information on the emergency administration of medication should the person require assistance e.g. EpiPen *

Yes

Not applicable

Statement: I can confirm that all members U18 years of age have signed a written parental consent form and these have been uploaded to SISWeb *

Yes

Required

Statement: I wish to confirm that this trip will be run in accordance with the Club’s UCD AUC Safety Manual and as per the AUC Trip Rules. *

Yes

Required

Where the group is travelling outside of Ireland, please provide the Travel Insurance company name and policy number for all those travelling. *

Where club equipment is being taken outside if Ireland please confirm that appropriate insurance cover has been put in place. Please provide the Insurance Company name and policy number. *

Name and contact details of person completing this form *

A copy of your responses will be emailed to the address you provided.

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