West Highland Wheelers Junior Mountain Bike Club
| Childs Name | |
| Date of Birth | |
| relevant medical informationeg: Asthma, ADHD, medication etc | |
| your name, address + email | |
| emergency contact number, name and relationship to child |
Please ensure your child takes any inhalers or medication he/she needs on the activity
Parent/ Guardian Consent form
I (name) …………………………….…….….………………………. being the parent/guardian of
……………….…….…………………………………………………………………………….
Understand and agree that the above named child participates in events organised by the Club entirely at his/her own risk. I understand the nature of mountain biking which includes rough terrain, and accept that accidents, including fatalities, can happen. I have considered and understand the nature of such events and have discussed them with the above named child. I am satisfied that the above named child is sufficiently responsible and competent to accept advice and instructions from the appointed group leader regarding their own and others safety whilst engaged in any event promoted or organised by the Club.
I acknowledge that a properly fitting cycling helmet must be worn by the above the named child and their bike must be in an adequately maintained condition when participating in club activities.
I Agree that the above named child shall participate in events organised by the Club without any liability whatsoever on the part of the organiser’s, or Club in respect of any injury, loss or damaged suffered by him/her, provided that this does not exclude the liability of any such party for the death or personal injury arising from that party’s negligence.
I confirm that the above named child does not have any disability or medical condition, physical or mental, that has not been disclosed above that could affect his/her ability to ride safely.
I confirm that the above named child is a member of The West Highland Wheelers
I agree to emergency first aid being administered at any time during Club activities, should this be necessary.
I give permission for photos and or videos of the above named child being used for advertising and promotional purposes – I agree to these being used for leaflets and posters / newspapers and magazines / web pages and social media.
Signed: (Parent/Guardian) Date: ………………………
Membership details shall be stored on database, for club purposes only.
Thank you for completing this form.