BCC Poolside Form 2020

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This information is required for insurance purposes with British Canoeing as well as for emergency contact purposes.

If you require further information or have any questions please ask before signing this form.

“Canoeing and Kayaking are ‘Assumed risk’ Water contact sports and may carry attendant risks. Participants should be aware of and accept these risks, and be responsible for their own actions and involvement.”

I understand that canoeing can be a hazardous activity and is undertaken at my own risk. I have read and understood the statement above and I wish to participate in the above activity.

Name of Participant……………………………………………………………………………………………………………

Address………………………………………………………………………………………………….

Postcode……………………………………………………………

Tel Home……………………………………………………………

Mobile………………………………………………………………..

Date of birth……………………………………………………….

Date…………………………………………Signature………………………………………………..

Please give an emergency contact, where a relative or friend acting for you, can be contacted.

Emergency contact Name: ………………………………………………………………………………………………….

Relationship to participant: ………………………………………………………………………………………………..

Date of Birth (if under 18) …………………………………………………………………………………………………..

Address: ……………………………………………………………………………………………………………………………

Post Code: …………………………………………………………

Tel home: …………………………………………………………..

Mobile………………………………………………………………..

If you have any medical conditions that we should be aware of that may affect you or others while undertaking this activity please download/obtain and complete the Paddle Consent form

Please indicate what you would like to experience from paddle sessions with Bramston Canoe Club?

Do you have any expectations of achievement in this session or in what period of time would you hope to complete this?

Notes for organisers: this form should be completed before any activity takes place and the relevant information should be made available to the person in charge. The original should stay with the nominated official and stored safely. It is important to update this information annually. info@bramstoncanoeclub.org. British Canoeing, Adbolton Lane, Holme Pierrepoint, Nottingham,NG12 2LU. www.britishcanoeing.org.uk. Correct 25/01/2020