Health Declaration Form (Tuition)

This page is a copy of the wording of the health declaration form you will be asked to fill in if you are over 16 and participating in watersports tuition at Colwyn Bay Watersports.

Health Declaration Form             (Tuition)

Name of Participants (Print):

Name of Emergency contact ashore (Print):

Number/details of contact ashore (Print):

 Health Declaration statement:

     Yes    No
I am over 16 and hereby knowingly agree that the participation in Watersports activities with Colwyn Bay Watersports is potentially strenuous activity with an element of risk and I declare that I am physically fit and able to participate in these activities.  
I am healthy and free from all relevant medication and injury.  
I consent to be photographed and I’m aware this photograph may appear in Colwyn Bay Watersports promotional material.
By taking part in RYA Courses I consent to my contact information being held by Colwyn Bay Watersports for marketing purposes and where needed passed to the RYA for qualification registration.  
I have read and understood the terms and conditions of the Colwyn Bay Watersports cancellation policy.  

If yes to all of the above: Please sign below.

If no to being free of medication and injury: I will make a member of Colwyn Bay Watersports staff aware, who will tell me the “Duty Senior” who is aware of any and all injuries and ailments that may be of concern inhibit or prevent participation or cause further injury during activities on the water. This will enable Colwyn Bay Watersports staff to take appropriate steps to enable me to access the Watersports activities, in line with the Colwyn Bay Watersports safety system. I have given details of my condition in the box below and I confirm my understanding of this form by signing below.

I accept that the Duty Senior’s word is final and that their decision is made in the interest firstly of health and safety, and secondly the enjoyment of all participants.

Customer Signature:                                                                                                                           Date:

 

Staff Member (Print):

Staff Member’s Signature:                                                                                                                  Date:

Brief description of any Medical Condition that the Waterfront should be aware of:

 

 

When completed please return to a Colwyn Bay Watersports member of staff