Available to download in the Health, Safety and Quality tab

Health Declaration

Please fill out the following form
in order to participate in our activity.

First name

Last name

Date of Birth

Are you in suitable physical health to particiate in the planned activity?

No, I cannot participate

Yes, I am suitable to participate

Are you suffering from a medical condition, illness, or injury?

Yes, please disclose below

If you answered yes, please elaborate

Initials

Statement: I declare that the information I’ve provided is accurate & complete. I understand that participation in adventurous activities entails some risk of injury and I will at all times proceed in a manner to limit the risk of injury as instructed by the leader/instructor/guide. However, I understand that accidents and injury may occur and I have read and understood the particulars of the Participation Statement. I undertake to inform staff of any changes in my health and fitness prior to departure. I understand that I will be familiarised with the hazards and will be expected to comply with instructions given by the leader/instructor/guide and any other health and safety guidelines. I give my permission for photographic and video images to be taken during my event and agree that these may be used in future publicity material.

Thanks for submitting!