Llandegfedd Sailing Club / RYA Power Boat Training Course Adult Medical Form

Power Boating Courses Powerboat2, Powerboat2 Direct Assessment, Safety Boat

Dates
Times
Fee / PAID
Your Name
Date of Birth
Your Address
Including Postcode
Your Telephone number / Mobile
Your Email Address
Previous Power Boat Experience (important for the Direct Assessment Course)
You need to provide a passport sized photograph so that an RYA certificate can be issued.

Each person taking part in this course must be a club member. If you are not a member, you must fill in a membership form and pay the fee before your application can be accepted.Each person must also fill in a Health Declaration and Medical Form.

Watersports are a physical activity and involve(low) risks of injury or drowning. All trainees must be water confident. All trainees must wear buoyancy aids (provided) and suitable clothing.There is a list of suitable clothing. You will get wet and you may get cold. Power Boating is a weather dependent sport so if conditions are unsuitable it may be necessary to postpone and rearrange sessions. We will endeavour to do so at times suitable to the group. There is a Feedback Form at the end of the course. Any problems or complaints should be raised with your instructors initially, or if necessary with the Senior Instructor. We hope you will enjoy your course. Good luck.

DISCLAIMER

RYA Instructors, RYA Senior Instructors, RYA Coaches do not accept responsibility for any loss, damage or injury suffered by persons/and or their property arising out of or during the course of their activities whilst training and/or coaching and/or instructing unless such injury loss or damage was caused by, or resulted from negligence or deliberate act.

I enclose a cheque for£______(or have paid already) and understand that no part of the fee is returnable if I cancel and the course places aren’t filled.

Signed / Dated

Illness or medical condition need not necessarily prevent you from taking part in the course but the Principal or Instructor must be aware of any potential problem. If you are in any doubt about your fitness to take part, please consult your doctor. The data collected below will be treated as confidential and only used in your benefit.

Your Name
Your Address
Inc Postcode
Your Telephone number / Mobile
Next of kin
Emergency Contact Number
Do you have any of the following medical conditions? If so, please provide any details that that the instructors need to know / Allergies, asthma, skin problem, heart problems, hearing problems, restricted use of a limb.
Please give details of any other conditions or circumstances affecting you that the instructors need to know
Please give details of any medicines or appliances that you will carry with you e.g. asthma pump

Health Declaration

In an emergency situation I give permission to the organisers to administer any First Aid treatment or medication, to take me to hospital/send for the emergency services and give my full permission for any treatment required to be carried out in accordance with the medical staff diagnosis.

Signed / Dated

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