Disclaimer and Medical Statement
(Please tick the relevant box, providing further information if required)
- Staff are not permitted to take responsibility for or to administer medicines. You are therefore responsible for ensuring any medicine is available and taken correctly
- You understand that whilst involved in the programme activities the Participant will be under the care of the community trust staff and other suitably approved adults. Whilst we will take all reasonable care of Participants you acknowledge that in the absence of our negligence, participation in the programme is at your sole risk and that we shall not be liable for damage or injury arising from activities
In the unlikely event of an accident occurring, you provide your permission for a designated representative of the community trust to authorise emergency medical treatment, including the use of anaesthetic if deemed necessary.
- During the course of NCS, activities may be recorded through photographs and video film both for the Participants to collate and celebrate their experiences but also for evaluation and promotional purposes by the community trust, The Football League Trust, the Cabinet Office and partner agencies.
You agree that the images may be used in media or publicity materials and celebration publications produced by those agencies.
You understand that these images may be safely stored or archived digitally or manually and may be publicised in a variety of media forms including managed social network sites.
Emergency contact details
In case of an emergency, who should we contact?
To receive further information about Scunthorpe Trust and related activities please provide a mobile number and / or email address:
The standard price of NCS is £50 as a contribution towards the entire costs. Financial support to reduce the cost may be available if required (for example if your son/daughter is entitled to free school / college meals). Please contact us at firstname.lastname@example.org for more information.
To secure your son/daughter's place you can pay via debit / credit card, cheque or cash. Our debit/credit card option will appear once you have completed and submitted this form. If you are paying via cheque, you can make a cheque payable to Sports Trust and this can be delivered to Scott Maxfield, Scunthorpe Trust, Glanford Park, Jack Brownsword Way, Scunthorpe, North Lincolnshire, DN15 8TD or Cash can also be haded in at the Main Reception, Glanford Park, Jack Brownsword Way, Scunthorpe, North Lincolnshire, DN15 8TD.
Consent For Water Related Activities
Travel and Collection Statement
PLEASE NOTE :
- During the programme the Participant will be responsible for getting to and from agreed venues, and will be allowed to leave without collection.
- For the residential venues or where transport facilities are provided as part of the project, the Participant will be responsible for getting to and from the designated meeting location. Participants will not be allowed to leave other than from that location, but will be permitted to leave from that location without collection.
- During the activities, for example as part of the Social Action Project, the Participant may be required to undertake travel unsupervised, either on foot or by public transport.
You give us permission to allow the Participant to leave designated locations (other than the residential or supervised trips) without collection, and to undertake some travel unsupervised
Once Completed we recommend that you take a copy of this form for your own Records