Edinburgh Rugby Camps Consent Form

Which Edinburgh Rugby Camp is your child attending?*

Please confirm the date of the camp

Participant Information

First name*

Last name*

Gender*

Date of birth*

Age Group/School Year (based on school year just completed)*

Which rugby club or school does your child currently play for?

Parent/Guardian Contact Details

First name*

Last name*

Phone number*

Email address*

Address*

Address

Address line 2

City

Postcode

Medical Information

Doctor's name*

Doctor's contact number*

Address*

Doctor’s Address

Address line 2

City

Postcode

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?*

If no, please note that the parent/guardian must remain within the facility should the child require assistance.

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

If yes, please provide details

Has your child been concussed within the last year?*

If yes, please provide details of when and how long out they spent out of contact rugby.

Agreements

Please confirm the below*

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 anesthetics that my child may require prior to my arrival

I agree to notify Edinburgh Rugby 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 agree to my child taking part in activities organised by Edinburgh Rugby staff

I confirm that all of the information above is correct.

Edinburgh Rugby 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.

Privacy Policy*

I have read and understood the privacy policy.

Edinburgh Rugby Camps Consent Form

Participant Information

Parent/Guardian Contact Details

Medical Information

Agreements

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