Parental Consent | Portishead CC

Parental consent and data protection notice

If you wish for your son/daughter to participate, then please read the following information, complete the form and sign the parental consent notice. All coaches are fully qualified British Cycling coaches that have received training in safeguarding and protecting children, and have been checked and cleared through the Disclosure and Barring Service. All fully qualified British Cycling coaches benefit from third party public liability and professional indemnity insurance cover.

Any information provided about your child will be securely and confidentially stored, processed and destroyed by British Cycling and Portishead Cycling Club in accordance with the principles of the Data Protection Act. It will only be used for the purpose of contacting you or your child regarding future events and clubs where your child could get involved in cycling; or to provide you with information about British Cycling membership.

With your permission British Cycling may also take photographs/video footage during the activity. These images may be used in coaching resources, presented at coaches education courses, placed on the British Cycling website or social media, or for general publicity purposes. If you are happy for photographs/video footage to be taken and used in this way, could you please tick ‘Yes’ in the photographs/videos permitted box overleaf.

Notes

A cycling helmet MUST be worn at all times during the activity.

Any participants who persistently misbehave or put others in danger will be asked to leave the activity and will not be allowed to continue.

Programme Details

Participant details

Participant's First name

Participant's Last name

Date of Bith

Sex

Male

Female

Street Address

Street Address Line 2

City / Town

County

Postcode

Emergency Contact Details

Name

Relationship to participant

Phone

Medical Information
Please make a note below and provide any information required about medical conditions you feel
we need to know about, e.g. asthma or any allergies. If you have any concerns about your child
participating in any form of physical activity then please consult your GP before giving permission
for your child to take part in the activities.

Medical infomation

Parental Consent Notice
I have read the information above and declare that i have the right to give parental consent, and hereby consent to my child taking part in the activity.

I agree to be at the drop-off/pick up point at the agreed time (if applicable). Not applicable to children taking part in school curriculum time.

I confirm to the best of my knowledge that my child in my care does not suffer from any medical condition other than those detailed in this form.

I confirm that I have provided details of any relevant medical condition that may affect my child taking part in the activity.

Parent / Guardian name

Your Signature

I agree thatmychild can be videod / photographed:

Yes

I agree to the terms & conditions

Thanks for submitting. Don't forget to book the session!