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Parental Consent Form 2015

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Bangor Open Bowls Tournament

PARENT/GUARDIAN/CARER CONSENT FORM


Please complete the following, sign and return, before commencement of play to:

Honorary Secretary
Bangor Open Bowls Tournament
c/o 18 Abbington Manor
Bangor
BT19 1ZQ
M: 07703107579

or

Honorary Secretary
Bangor Open Bowls Tournament
Tournament Desk
Ward Park Pavilion
M: 07703107579

Name of Young Person: .


Date of Birth:

Bowling Club:

Parent/ Guardian / Carer:


Name:

............................

Address: ....
.....

Postcode: ..

Tel (day): ............... Tel (evening): ...................


Mobile: .. Email: ...........................
Family Doctor: . Doctors Tel No: ..........
Does your child suffer from any medical conditions/allergies that the Tournament
should be aware of (including any current medication?)
....................................................................................................................
........
Emergency Contact Details: (If different from above)
Name: Telephone no: ....
Relationship to Young Person: .................

CONSENT (please read carefully)


a) I agree to my son/ daughter taking part in the Bowls Tournament.
b) I confirm to the best of my knowledge that my son/ daughter does not suffer
from any medical condition other than those listed above and is deemed fit
and able to participate.
c) I understand that the Tournament accept no responsibility for loss, damage
or injury caused by or during attendance except where such loss, damage or
injury can be shown to result directly from the negligence of the
Tournament. First Aid and Child Protection Officer in attendance.
Signed: ..................... (Parent/ Guardian/ Carer)
Date:

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