West Country Swords

Fencer Name *

First

Last

Gender *

Age *

Weapon *

Payee Name *

First

Last

Payment Method *

Email *

Contact Number *

Emergency Number *

Subscribe to the West Country Swords mailing list *

Yes No

Subscribe to the Hereford & Worcester County Fencing Union mailing list *

Yes No Different County

Club *

Coach(s) *

Injuries *

If yes, please give details below: *

Medical Conditions: *

Current Medication: *

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

Yes No

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

Yes No

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

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 West Country Swords, 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. West Country Swords 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.

Training Day - 29th May 2019

Waiver & Liabilty Disclaimer Agreement