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Medical and Consent Form
Adults off site with outdoor pursuits
First Name (*)
Please let us know your name.
Surname (*)
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Your Email (*)
Please let us know your email address.
Work Phone
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Mobile
Please write a subject for your message.
Home Phone
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Address Line 1 (*)
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Address Line 2
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County (*)
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Postcode (*)
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Select your programme start date (*)
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Programme Reference (*)
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Are you attending with your work? (*)
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Enter your company name
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It is vital that we are aware of all existing medical issues or medical conditions/illnesses/allergic reactions that you have (e.g. food allergy – please specify foods, asthma, heart conditions, pregnancy, back problems) and any medication that is used to control these conditions (e.g. inhaler, adrenalin etc): If you have an existing medical condition, we recommend that you take advice from your GP to establish what sort of activity it is safe for you to take part in on your programme. To minimise the risk of picking up insect bites in the outdoors environment we recommend you wear long trousers and stout footwear. This is good practice in countryside areas. Please refer to our suggested kit lists.
Do you have any existing medical conditions?
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Please provide details of any existing medical conditions and any current medications
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Doctor's Name (*)
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Doctor's Phone (*)
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Next of Kin (*)
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Relationship to next of kin (*)
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Kin Home Phone (*)
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Kin Mobile Number
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Provided that we are given at least three working days notice we can normally cater for special dietary requirements eg vegetarian, vegan or any allergies. To allow for food preferences our standard menus offer plenty of choice.
Do your require a special diet? (*)
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Please provide details of special dietary requirements
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Please provide your height in feet and inches (required for bike hire)
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I have read, understood and correctly completed this form. I have declared all of my existing dietary and medical conditions. I agree that I will not take part in any activity that I know may aggravate an existing medical condition that I have. I agree to take responsibility for my personal belongings whilst on my programme. I agree to be a responsible participant on the programme. If agree that if I drink alcohol at the end of an event day, I take full responsibility for my behaviour whilst under the influence of alcohol and any alcohol-induced incidents that may arise from my actions. I understand that I may only consume alcohol obtained from the Woodland Bar at the New Forest Outdoor Centre and that no other alcohol may be brought onto the site. I agree that any photographs or digital images taken at The New Forest Outdoor Centre may be used by the New Forest Outdoor Centre for publicity purposes. I understand that the New Forest Outdoor Centre may use my email address to send me information about the programme or session I have attended. I understand that my details will NOT be passed on to any other companies or parties. I declare that I am aware that outdoor activities carry a certain element of risk and that I understand those risks and accept them as part of the activities enjoyment.
Check to confirm (*)
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Prove you are human
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