Chichester Water Sports Trip – St Mary's Fittleworth

We are really looking forward to our trip to Chichester Watersports Centre on 13th September 2020. Please could you fill in the form below for each individual young person attending that you are responsible for.

Many Thanks.
The Rock & Horizon Team

Young Persons Details

Young Person’s Name

Date of Birth

Street Address

City

ZIP / Postal Code

Phone

Email Address

Emergency Contacts

Emergency Contact 1

Emergency Phone 1

Emergency Phone 2

Emergency Contact 2

Medical Information

Doctor

Doctor’s Phone

Street Address

City

ZIP / Postal Code

Any Medical Information

Permissions

CheckboxI give permission for the members of The Rock and Horizon team to seek medical attention for the person named above if they deem this necessaryI will not hold the team leaders or St Mary’s Church Fittleworth responsible for any damage and loss of possession or any harm that may occur to the person named above.I understand and accept that my child will be transported to the venue via private vehiclesI am happy for my child to be included in videos and photos that maybe used in St Mary's Fittleworth Publicity; including their website and facebook profiles (names will remain anonymous)

GDPR *

I accept and understand that the information in this form will be kept for the purpose of the event being attended and will not be shared with any third parties unless required for emergency purposes.

Name

Relation to Young Person