Participation Statement

“The British Mountaineering Council recognises that climbing and mountaineering are activities with
a danger of personal injury or death. Participants in these activities should be aware of and accept
these risks and be responsible for their own actions and involvement.”

Child details

Event Date (required)

Event (required)

Childs Full Name (required)

Childs Date of Birth (required)

 Male Female

Parent / Guardian details

Parent / Guardians Name (required)

Your Email (required)

Your Address(required)

Your Contact Number (required)

Emergency Contact details

Emergency Contact Name (required)

Emergency Contact Number (required)

Medical Details

Does your son/daughter have any
medical problems you feel we should
know about? (include all details about
Asthma, Diabetes, Epilepsy if applicable)

Medicine/Tablets

Allergies

Dietary requirements

Other treatments

His/Her National Health Service
Medical Card No (if known):

Doctors Contact Details

Any Religious needs

Parental Consent

I am aware that climbing, hill walking and mountaineering are activities with a danger of personal injury or death. I have understood the
nature of the activity and accept the risk involved. I confirm I am the parent/guardian of the above named child and that I consent for him
or her to take part in the Onsight Coaching Outdoor Sport Climbing course.

 Accept

Initials (required)

Date (required)