Teens Consent Form

Teen's Details
First Name (required)

Last Name (required)

School (required)

Class (required)

Date of Birth (required)

Address

Parent's Name (required)

Parent's Email (required)

Emergency Contact
Name (required)

Phone Number (required)

Relationship to Teen

Alternative Emergency Contact
Name

Phone Number

Relationship to Teen

Medical Information
Please give details of allergies, medication and any relevant medical conditions.

In the unlikely event of injury, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my teen should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication.

Collecting Your Teen
My teen will be picked up by:
My signing out password is:
My teen is to walk home on their own: —Please choose an option—YesNo

Photography
Nordic4 would like to sensitively use personal images by photography or video recording for marketing purposes including social media. Teen names will not be used.
I give consent to photographs being taken of my teen and used for marketing/social media purposes.

Data Protection
Your information will be stored securely by the instructor and will not be given to anyone else. You must notify your instructor of any changes in your personal data. Your email address or phone number will be used to notify you about Nordic Walking activities/changes to sessions due to weather conditions. This is in accordance with our Privacy Policy.
I agree that my submitted data is being collected and stored. (required)

Consent
I agree to my teen taking part in the walking activities run by Nordic4Kids. I understand that Nordic4 Instructors hold qualifications in teaching Nordic Walking, are fully insured and are qualified in Outdoor First Aid. I agree that my teen should abide by the code of conduct, explained clearly to all pupils at the start of a session while in the care of a Nordic4 Instructor. I understand that a serious infringement of this code may result in my teen being prevented from continuing with the activities. (required)