Under 18 disclosure form

Under 18 disclosure form

Please complete the following in full

Under 18 participant details

Name

Date of birth

Age

Address

Contact number

E-mail address

EMERGENCY CONTACT DETAILS: These details will be carried with the coach to each session you attend. They will be kept securely out of sight and only presented should an emergency situation arise where these would be required.

FIRST CONTACT

Name

Relationship

1st tel no

2nd tel no

SECOND CONTACT

Name

Relationship

1st tel no

2nd tel no

MEDICAL AND SPECIFIC NEEDS: The details you provide below will ensure a session can be tailored to minimise risk of injury or harm to your child and/or others. In some cases a risk assessment may need to be carried out based on the information disclosed.

Please give details of any medical or health conditions that may affect your child's participation in SwimFit Midlothian sessions

Please list any medications your child takes on a regular basis

Please give details of any specific needs that the coach should be aware of and what support/modifications are needed

Safety Guidance

PREVENTION

Each participant in lessons is expected to behave in a safe and respectful manner. Failure to do this can put all participants safety at risk and therefore children behaving in an inappropriate manner will be asked to leave the session. As the parent/guardian of the participant, you are accountable and responsible for them and their actions. This includes providing correct information on medical conditions, medication required and disclosing disabilities that could compromise their safety and that of other participants in the session or pool users.

EMERGENCY

Whilst all steps are taken to ensure the safety of all participants and the coach, emergency situations can occur. In an emergency:

The lifeguard should be called upon immediately
Participants in the water will remain still until directed to exit the pool by either the coach or lifeguard.
The coach will follow direction from the lifeguard team
Participants will follow the direction of the coach.

ASTHMA

Most asthmatics will not be exercising if they feel they are having an asthma attack. Occasionally asthma attacks can become severe. In this situation the coach and/or lifeguard will ensure the safe exit from the water and immediate assistance given. Inhalers must be carried by the parent/guardian and available throughout the session

Declaration & Consent

By clicking the checkbox below. I give consent for my child to take part in SwimFit Midlothian Sessions. My signature also confirms I have read and agree with the following:

I will remain responsible for my child immediately before and after a session. I will remain in the viewing gallery throughout the session if my child is aged 12 or under
I understand the coach works both in and out of the water during swim sessions. Where required, the coach will support my child’s body to progress their swimming development
To the best of my knowledge, my child is fit and healthy and able to participate in SwimFit Midlothian Swimming and/or Strength & Conditioning Sessions that I have requested for them to join. He/she has not been advised by a doctor to avoid exercise
My child should receive emergency medical treatment or first aid by a qualified practitioner or first aider if such a situation arises
I will inform the coach should my childs health and fitness change
I have read SwimFit Midlothian’s Terms & Conditions, Privacy Notice and Safety Guidance.

I agree to the above declaration

Relationship to child

Date

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