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2017/2018 Parent/Guardian Consent Form

I, being the parent/guardian of the child/children identified below, have read the information on this form and in the following notes give my consent for my child to take part in the junior coaching sessions organised and run by WaldenJNR.

I understand and agree that my child participates in coaching sessions under the instruction of British Triathlon Federation (“BTF”) coaches entirely at his/her own risk.

I have considered the nature of such sessions and have discussed them with my child. I am satisfied that they are sufficiently responsible and competent to assume full and entire responsibility for their own safety under the supervision of a BTF Coach.

I apply for my child/children to become a Junior Member of WaldenJNR and agree to pay the 2017/18 membership fee of £10 (or £5 if after 30th June 2018). In doing so I agree that my child will comply with the rules of the club and abide by the club’s code of conduct applicable to Junior Members. You will receive a PayPal e-mail invoice for the membership fee in due course.

Notes:

  • You are giving consent for the child named below to participate in coaching sessions.
  • It is part of the Code of Practice for Triathlon Coaches to ensure that reasonable steps are taken to establish a safe environment where young participants can enjoy developing their triathlon skills. You are welcome to stay and watch sessions, but this is not mandatory.
  • Participants must wear appropriate kit for all training sessions and always wear a cycle helmet while riding their bike.
  • Any participants who persistently misbehave or put others in danger will be asked to leave the session and may not be allowed to attend in the future.
  • Parents must advise the coach responsible for the session of any medical condition your child has and you feel the coach should know about.
  • If you have any concerns about your child participating in any form of physical activity, please consult your GP before giving permission for your child to participate in the coaching session.
  • Parents/guardians should respect the coaching timetable by i) arriving in good time so that a prompt start to the session is possible and ii) arriving to collect your child at the advertised finish time.
  • If you are unable to attend a training session you are expected to inform the Group Leader, using the email address on the Group page of the website.
  • If you have any concerns about the sessions or about your child’s welfare, please speak to the coaches or to the club’s Welfare Officer.

First Child Details:

Forename:(*)
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Surname:(*)
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Date of Birth(*)
/ / Invalid Input

Gender:(*)

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Child's email address:
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DO NOT ENTER THE PARENT/CARER EMAIL ADDRESS HERE

please leave blank unless you want you child to receive the weekly newsletter on their own e-mail account

School:(*)
Invalid Input

Select school from drop down list.

Name of other school(*)
Invalid Input

School year:(*)
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Select school year from drop down list

Does the child a Special Educational Need?(*)

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SEN Details(*)
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Does the child have an allergy or medical condition?(*)

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Details of Medical Conditions and/or Allergies(*)
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Disability:(*)

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Do you consider the participant to have a disability?
The Disability Discrimination Act 1995 defines a disabled person as anyone with a “physical or mental impairment that has substantial and long term adverse effect on his or her ability to carry out normal day-today activities.”

Nature of the disability:(*)
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Ethnic Group(*)

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Do you wish to add a second child?(*)

Invalid Input

Second Child Details:

Forename(*)
Invalid Input

Surname:(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

Gender(*)

Invalid Input

Child's email address:
Invalid Input

DO NOT ENTER THE PARENT/CARER EMAIL ADDRESS HERE

please leave blank unless you want you child to receive the weekly newsletter on their own e-mail account

School(*)
Invalid Input

Select school from drop down list

Name of other school(*)
Invalid Input

School year:(*)
Invalid Input

Select school year from drop down list

Does the child a Special Educational Need?(*)

Invalid Input

SEN Details(*)
Invalid Input

Does the child have an allergy or medical condition?(*)

Invalid Input

Details of Medical Conditions and/or Allergies(*)
Invalid Input

Disability:(*)

Invalid Input

Do you consider the participant to have a disability?
The Disability Discrimination Act 1995 defines a disabled person as anyone with a “physical or mental impairment that has substantial and long term adverse effect on his or her ability to carry out normal day-today activities.”

Nature of the disability:(*)
Invalid Input

Ethnic Group(*)

Invalid Input

Do you wish to add a third child?(*)

Invalid Input

Third Child Details:

Forename:(*)
Invalid Input

Surname:(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

Gender:(*)

Invalid Input

Child's email address:
Invalid Input

DO NOT ENTER THE PARENT/CARER EMAIL ADDRESS HERE

please leave blank unless you want you child to receive the weekly newsletter on their own e-mail account

School:(*)
Invalid Input

Select school from drop down list.

Name of other school(*)
Invalid Input

School year:(*)
Invalid Input

Select school year from drop down list

Does the child a Special Educational Need?(*)

Invalid Input

SEN Details(*)
Invalid Input

Does the child have an allergy or medical condition?(*)

Invalid Input

Details of Medical Conditions and/or Allergies(*)
Invalid Input

Disability:(*)

Invalid Input

Do you consider the participant to have a disability?
The Disability Discrimination Act 1995 defines a disabled person as anyone with a “physical or mental impairment that has substantial and long term adverse effect on his or her ability to carry out normal day-today activities.”

Nature of the disability:(*)
Invalid Input

Ethnic Group(*)

Invalid Input

First Parent/Carer Details:

Forename(*)
Invalid Input

Surname(*)
Invalid Input

Relationship(*)

Invalid Input

Home Tel:(*)
Invalid Input

enter number without any spaces.

Mobile:(*)
Invalid Input

enter number without any spaces.

E-mail address:(*)
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A confirmation email will be sent to this address once the form is submitted, and the address added to clubs parentmail list on MailChimp which is used for all club communications.

Second Parent/Carer Details:

These details are optional, but giving them ensures the weekly newsletter is sent to both parents and can help if we need to make contact in an emergency.

Forename:
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Surname
Invalid Input

Relationship

Invalid Input

Home Tel:
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enter number without any spaces.

Mobile:
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enter number without any spaces.

E-mail address:
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The address added to clubs parentmail list on MailChimp which is used for all club communications.

Other Details:

Email address for fees(*)

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Membership and Term Fees are sent via a Pay Pal Invoice. Select the address you would like us to use.

Photography/Filming:

To help promote or evaluate the club's activities and achievements there may be video filming and photography at some sessions or competitions. Your authorisation is requested to use photo(s) of your child/children in publications including: club website, Flickr site , marketing, leaflets, or any other use such as for training, educational or publicity purposes. If used the club will ensure that images are not accompanied by names or other details that could identify individual children. Our full photography and video policy is available here.

Photography Filming Agreement(*)

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Do you agree to give the club permission to use any still and/or moving image being video footage, photographs and/or frames and/or audio footage depicting my/our child.

Please tick(*)
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