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North Wales VA & Mountaineering
Drakes Island
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PARTICIPANT CONSENT
Before taking part in a Cadre activity, please complete the form below.
First name
*
Last name
*
Email
*
Mobile phone
*
Event being undertaken
Date of event
Emergency Contact Name
*
Emergency Contact Number
*
Relationship
*
Do you have any medical conditions, injuries, allergies, disabilities or other health information that may affect your participation?
*
Yes
No
Will you be carrying any medication that may be needed during the activity?
*
Yes
No
Please read each statement carefully and tick each box to confirm.
I understand that climbing, mountaineering and outdoor activities involve inherent risks that can't be completely removed.
I agree to follow the instructions and safety guidance given by my Cadre instructor.
I'll tell my instructor if I feel unwell, unsafe, unable to continue or don't understand an instruction.
I confirm that the information I've provided is accurate to the best of my knowledge.
If I become ill or injured and I'm unable to make the decision myself, I consent to Cadre seeking appropriate emergency medical assistance on my behalf.
We sometimes take photographs and video during Cadre activities for use on our website, social media and promotional material. Your choice won't affect your ability to take part.
Yes, I consent
No, I don't consent
I confirm that I've read and understood the information above. I understand the nature of the activity and that climbing, mountaineering and outdoor activities involve risks that can't be completely eliminated. I confirm that the information I've provided is accurate and I consent to taking part in the activity.
Participant full name
*
Signature
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Date picker
Is the participant under 18 years old?
*
Yes
No
Your information
Cadre GP Ltd will use the information provided on this form to manage your participation, safety and, where necessary, emergency arrangements. This may include health information you choose to provide. Your information will only be accessed by people who need it for these purposes and will be handled in accordance with Cadre GP Ltd's Privacy Policy.
SUBMIT CONSENT FORM
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