Check the box if you want to add another child or adult to the booking. Check both boxes if you want to add both.

Emergency Contact Details

Declaration & Consent

General Declaration

• I agree to my son/daughter attending the proposed rugby tour • I consent to my son/daughter taking part in the activities indicated • I have ensured that he/she understands the importance of his complying with the rules and instructions given by the adults in charge • I accept that I may be required to bear the cost of any loss or damage that he/she causes. • I agree that photographs may/may not be taken of my son/daughter and if I agree to photographs being taken they can be used by WRFC. • I have received comprehensive details of the above tour and am aware of the RFU Policies and guidelines in relation to tours • I agree to be at the pick-up/drop off point at the agreed time • I agree that the information provided can be used for the sole purpose of delivering the tour and that it will be kept and processed in accordance with the Clubs Data Protection Policy . I understand that I have a right of access to the information, and that I have the right to withdraw my permission and my information at any time.

Consent

1. I confirm to the best of my knowledge that my son/daughter does not suffer from any medical condition other than those detailed. 2. I authorise a member of the Tour Management who holds a first aid qualification (or any other person equally qualified and authorized by the Tour Management) to administer emergency first aid treatment where this is necessary. 3. In the event of a serious illness or accident requiring medical treatment; (a). I agree to my son/daughter receiving treatment including surgical operation, anesthetic, or serum injection (except as detailed in "exceptions" below) as considered necessary by medical professionals; and (b). I agree to this treatment being authorised by a member of the Tour Management, who may sign any written form of consent required by hospital authorities, providing that the probable delay to obtain my signature is considered by a doctor, likely to endanger my son’s/daughter’s health or safety. 4. I understand that the Tour Management and voluntary helpers will take all reasonable care of my son/daughter but cannot necessarily be held responsible for any loss, damage or personal injury suffered by him/her.
You can either draw your signature on a touch screen device, or use your mouse by holding down the left button and drawing it that way.
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