Medical Liability Form

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I hereby release and absolve KCL Gymnastics, its subsidiaries, directors and staff from all liability and responsibility for injuries, sickness, accidents, loss of money and property that may be sustained whilst participating at the KCL Gymnastics sessions throughout the 2022/23 academic year.

I hereby acknowledge the risks involved when taking part in these sessions and confirm that I am able to use medical care or have individual athletic insurance (KCLSU or British Gymnastics insurance) in the unlikely event of an injury or accident when taking part.

In consideration of me signing this release form, I am allowing myself to participate in this sessions and intend to be legally bound and agree to waive and release all rights to claims from damages which I may sustain or suffer whilst participating, including travelling to and from the sessions.

As a member of KCL Gymnastics I confirm I will use the skill handbook provided at my own risk. I will not attempt progressions listed in the handbook without approval from a qualified coach and will participate within my own capabilities.

Email *

Full Name *

Date of Birth *

YYYY

Medical Details: Please disclose any medical issues that we should be aware of (e.g. chronic ankle/wrist/back problems, food allergies, diabetes, asthma) *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Number *

I also give permission for myself to be photographed, video or audio-taped during these sessions, and give permission for such photographs, video and audio tapes to be used in print or broadcast through any media which is deemed appropriate for the promotion of KCL Gymnastics activities, promotions and publicity.
*

I give permission

I do not give permission

Signature (Full Name) *

Date *

YYYY

Send me a copy of my responses.

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