HomeMedical Participation Form Medical Participation Form Yorkshire Adventure Company Participation Statement, Acknowledgement of Risk and Medical Declaration Form'Outdoor adventure activities are activities with a danger of personal injury or death. There have been serious injuries and fatalities associated with the participation of such activities. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.'The above statement is relevant to each and every activity run by Yorkshire Adventure company.Consent I acknowledge the above statement of participation and understand the risks associated in the activity chosen and I accept that it is impossible to completely protect myself (or my child) from these risks. I agree to be responsible for my own (and my child's) actions and agree to adhere to the instructions and advice given by the activity leader and ask for clarification if I am unsure of the instructions given as I understand that failure to do so could lead to injury or death. I accept full liability for any injuries or death as a result of ignoring safety procedures and instructions given by the activity leader.Consent I accept the activity I have chosen is physically demanding and I am fit and healthy enough to take part (as is my child). I have declared all past and present medical, physical or mental health condition as well as any allergies which in my opinion or that my GP or Hospital Consultant may affect my ability to carry out this activity safely (or my child's ability). I understand that failure to disclose such information can lead to injury or death and in such cases Yorkshire Adventure Company cannot be held responsible. I consent to my information being shared with medical personnel in the event of an incident where I am unable to give the information myself.Consent I consent to any photograph and/or videos taken of me (or my child) being used by Yorkshire Adventure Company for promotional purposes on social media, websites and company literature.Consent I accept that taking a mobile phone, camera or any other personal item onto this activity may result in items being lost or damaged and I accept full responsibility should this occur. I agree that any such item must be securely fixed to the user and must not pose a threat to the safety of the user or others in the group or affect the smooth running of the activity. I understand and agree that Yorkshire Adventure Company accepts no responsibility for my vehicle and its contents while taking part in the activity. I understand that if I give my key or any other item(s) to the instructor to keep either in their van or to take in the instructors bag during the activity the item(s) could be lost, damaged or even stolen from the instructors van if it is broken into and I accept full responsibility if this should occur.By submitting this form you are agreeing to the above statements, you understand and accept the risks in the activity and you wish to take part (as a parent/legal guardian you are also agreeing on behalf of your child). Unfortunately any participant without a signed consent form from a parent/guardian will not be able to take part.Name First Last Date of birthEmergency contact Name Phone number Medical informationNameThis field is for validation purposes and should be left unchanged.
