FOSROC Rugby Camps Consent Form

FOSROC Camps Consent Form

Which FOSROC Rugby Camp is your child attending?(Required)

How did you find out about the FOSROC Rugby Camps?

Child's Details

Child's Name

First

Last

Gender

Date of Birth

Child's Rugby Club or School

Parent or Guardian Details

Name

First

Last

Address

Street Address

Address Line 2

City

County / State / Region

ZIP / Postal Code

Country

Phone

Medical Details

Doctor's Name

First

Last

Phone

Address

Street Address

Address Line 2

City

County / State / Region

ZIP / Postal Code

Country

Would you consider your child to have a disability?

If yes, please provide details including any assistance your child may require.

Does your child suffer from any medical conditions requiring medical treatment?

If yes, please provide details

Does your child self administer their required medication?

Does your child suffer from any allergies (i.e foods, medicines etc)?

If yes, please provide details

Consent

I consider that my child is in good health and capable of taking part in these activities

In the event of an emergency I consent to any emergency medical / dental treatment to include the use of anaesthetics that my child may require prior to my arrival

I agree to my child taking part in activities organised by Glasgow Warriors staff

I agree to notify Glasgow Warriors staff of any changes to the information given on this parent/ guardian consent form for the duration of the sessions.

I agree to my child being filmed or photographed with the possibility that these might be used for publication and or publicity

I confirm that all of this information is correct

Glasgow Warriors as part of Scottish Rugby are committed to protecting your personal information and respecting your privacy. Our Privacy Policy sets out the purposes for which we will collect, hold and use your personal information and how this might be shared with third-parties. It also explains your rights to access your personal information.

FOSROC Camps Consent Form

Child's Details

Parent or Guardian Details

Medical Details

Consent

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