West Country Swords

Summer Camp ~ Day Rate Form

* Indicates required field

Camp *

Summer

Fencer Name *

First

Last

Sex *

Age *

T-Shirt Size *

Water Bottle *

Payee Name *

First

Last

Email *

Contact Number *

Emergency Number *

Weapon *

Club *

Coach(s) *

Experience/Ranking *

Injuries *

If yes, please give details below: *

Medical Conditions: *

Current Medication: *

Permission for your child to attend the course and receive treatment (if required) by the School Staff, Sports Therapist and Coaches. *

No Yes

Permission to take photographs of your child for publicity purposes. *

No Yes

Permission to take photographs/videos of your child for coaching, analytical and feedback purposes. *

No Yes

Parent/ Gaurdian's Name *

First

Last

If the applicant is under 16 then the name of the person giving his/her permission must be stated in the box provided

Athlete Information Form

Dietary Requirements

Please indicate below details of any special dietary needs, food allergies, or intolerance. Please do not include food preferences, likes or dislikes. Please be specific and include as much detail as possible.

Other Dietary Need/ More Information: *

Medical Requirements/ Injuries

Please provide any medical conditions in the box below: *

Please provide any injuries in the box below: *

Health and Safety guidelines are very strict about the issue of medicines administered and we are required to have your consent to give your child calpol or paracetamol should the need arise. If consent has been given, Parents will be notified once medication has been administered.

If you consent to the administering of calpol or paracetamol to your child should the need arise. Please give permission below: *

Yes No

If your child is on medication and you wish for a member of staff to administer any medication. Please give permission below: *

Yes No

Swimming Consent

Permission for your son/daughter to take part in any swimming sessions. *

Yes No

Parent/ Guardian Signature *

National Governing Body (NGB) Membership

Please provide your National Governing Body (NGB) membership number in the box below. All athletes attending the Summer Camp must have a current license with their respective NGB. If you need a British Fencing License please click here.

National Governing Body *

Membership Number *

Expiry Date *

Camp Rules

By applying to attend the camp, you and your parents have agreed to abide by the ‘Campus Rules’ and the authority of the coaching team and staff. All fencers attending the course must abide by these rules, anyone found to be breaking the rules will be asked to leave the course immediately.

The 'Fencer' understands and agrees to the Campus Rules. *

Yes

Fencer Signature *

Marketing and Advertising

Please select preferred options for future marketing. Please be aware that if you click 'none' you may not receive any future information from West Country Swords regarding training camps, training days, competitions and any other events we hold.

Please select preferred option(s) *

Email Post SMS None

Waiver & Liability Disclaimer

ASSUMPTION OF RISKS: Fencing is a physical activity which, by its very nature, carries with it a certain inherent risk that cannot be eliminated regardless of the care taken to avoid injuries. Fencing classes include activities that involve strenuous exertions of strength using various muscle groups, quick movements involving speed and change of direction, and sustained physical activity which can place stress on the cardiovascular system.

The specific risks vary from one activity to another, but the risks range from minor injuries such as scratches, bruises, and sprains to major injuries such as eye injury, joint or back injuries, heart attacks and concussions.

WAIVER OF LIABILITY: In conclusion of my (my child’s) participation in the sponsored activities of the arranged by West Country Swords and its associates, I acknowledge, agree to and understand that: I am fully aware of and appreciate the risks, including the possible risk of serious injury associated with my (my child’s) participation. I further agree on behalf of myself, my heirs, and personal representatives, that Daniel Robinson, along with volunteers, agents, and lessee of the premises, shall not be liable for any injury, loss of life or other loss or damage occurring as a result of my (my child’s) participation in the sessions provided, or as a result of equipment that may have been provided to me for those activities.

DAMAGES & LOSS
Participants are respectfully advised that all personal property including sports equipment, clothing and money remains the sole responsibility of the participant. Daniel Robinson and its associates and will not be liable for any claim or expenses arising directly or indirectly as a result of loss, theft or damage to the personal belongings of any individual.

CONSENT FOR MEDICAL TREATMENT: This is to certify that I give my consent to West Country Swords & associates to obtain medical care from any licensed physician, hospital or clinic for the above named Participant for any injury or illness that may arise during activities associated with fencing classes or competitions.

You agree that we may publish your Personal Information as part of the results of the Event and may pass such information to any governing body or any affiliated organisation for the purpose of insurance, licences or for publishing results either for the event alone or combined with or compared to other events. Results may include (but not be limited to) name, any club/home country/regional/county affiliation, results, age category, penalties.

You also agree that in the event of a disciplinary or welfare incident that you are either involved in or witness, we may pass on your personal information to British Fencing or any other relevant Authorities for the purposes of supporting any investigatory activity into that incident.

Waiver & Liabilty Disclaimer Agreement *

By ticking the box you agree to the terms stated above.

I agree to receiving marketing and promotional materials