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Medical/Consent Form

This form must be filled out for all persons attending and signed by a legal guardian for those under 18. The information given is confidential and is only available to staff who need to know for reasons of safety etc. They are kept for 3 months after each course, and then destroyed.

 

Date: July 6, 2025

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 19 years of age or older
First Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
I consent for the person named above to take part in the activities outlined in the itinerary. Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 19 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 19 years of age or older
Parent or Guardian's Information
Course Type:
Course Dates:
Mobile Phone

Please give details of any medical conditions that may affect the course member's ability, including advice given by a doctor. Course members are rarely excluded from an activity due to a medical condition, so please do not miss anything out.

Please indicate if the course member will be taking any medication during the course, and who is responsible for it.

Please note Staff are not allowed to administer any medicines whatsoever, and do not have any medications available such as insect creams or aspirin. However, instructors are trained in first aid, carry first aid kits and will look after medications for those under 18 (e.g. inhalers) if written evidence is given that the medication is required.

Dietary Information


If being catered for, please include any special diets, food allergies etc. (e.g. vegetarian, peanut allergy etc).
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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