Consent Form

I agree that my child is in good health and I consider him/her capable of taking part in physical activities with Witham Running Club.

Declaration

IN THE EVENT THAT MY SON/DAUGHTER REQUIRES EMERGENCY MEDICAL TREATMENT I AUTHORISE THE JUNIOR COACH OF WITHAM RUNNING CLUB, TO SIGN ON MY BEHALF ANY CONSENT FORM REQUIRED BY A QUALIFIED MEDICAL PRACTIONER FOR SUCH TREATMENT.

Consent Form

Child's Details

Person with Parental Responsibility

It is important that we have up-to-date information so that parents or guardians can be contacted in an emergency.

Medical Information

In case of emergency are there any medical conditions that we should know about? Does the athlete use an inhaler? Please fill in the details below.

Sending