Online Consent Form for u18s

MWRL Parental Consent Form

To be completed by a parent or legal guardian for all children and young people (14 - 18 years old) taking part in Rounders sessions, training and matches.
The information contained in this document will be held securely by the Captain and the Committee. This information will not be shared outside of MWRL.

Name of Team *

Childs Name *

Parent/Guardian Name(s) *

Contact Email address *

Home Address *

Post Code *

Contact Number *

Date of birth (DD,MM,YY) *

Gender *

Male
Female
Non Binary
Other

Gender - If selected 'non binary' above, Please add a short explanation below

Gender - Is your gender identity the same as the sex you were assigned at birth *

Yes
No

Ethnic origin *

Details of activity. Dates, Times, season, Location *

Emergency Contact name *

Emergency contact number *

Emergency Contact number - Alternative *

Childs doctor's name and contact number *

Does your child experience any conditions requiring medical treatment and/or medication? *

Yes
No

If yes, please provide details

Does your child have any allergies? *

Yes
No

If yes, please provide details

Does your child have any specific dietary requirements? *

Yes
No

If yes, please provide details

Please provide any further information you feel is necessary?

Declaration. By digitally signing this form I hereby confirm I am the legal guardian of the child stated within this form and i confirm consent to the statement below *

I have received comprehensive details of the above activity and am aware of MWRL's Safeguarding Policy
I consent to my child taking part in the activity detailed above.
I agree to be at the drop off/pick up point at the agreed time.
i confirm to the best of my knowledge that my child does not knowingly suffer from any medical condition other than those detailed above
I consent to my child receiving emergency medical treatment which, in the opinion of a qualified medical practitioner, may be necessary.

Digital signature - Type name below *

Send me a copy

Online Consent Form for u18s

MWRL Parental Consent Form

Hard Copy if needed