Medical Information

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All persons taking part in activities must complete the following fields as fully as possible prior to activity commencement. All information given will be treated with the strictest confidence.

1. Coronavirus (COVID-19)

Are you showing any signs/symptoms of Covid-19 now or within the past 14 days?

Have you, or any member of your household, been in contact with anyone showing signs/symptoms of Covid-19 in the past 14 days?

** You should NOT attend or take part in any activity if you, or a member of your household, have been displaying any signs or symptoms of COVID-19, or if you have been in contact with anyone showing signs/symptoms of Covid-19 now or in the last 14 days.**

2. General Medical Details

Do you have any medical conditions?

Are you receiving any medication or treatment?

Do you suffer from allergies? i.e. stings, bites, penicillin, elastoplasts etc

Are you prone to repetitive sports injuries?

Can you swim?

Do you have any dietary needs?
i.e. vegetarian, celiac etc (only applicable if ordered packed lunches)

Are there any areas we have not yet covered that you feel may be relevant?

Please provide your approx. Height & Weight.

Emergency Contact Details

please provide Surgery Name, Town, Postcode

If the above details are correct, please proceed to the final page - Disclaimer.