• Bridgwater 2022 - Health Form

    This form must be completed by a parent or guardian.

  • If your child has particular emotional needs, disabilities, special needs or behavioural problems, please contact David White as soon as possible. This will enable us to take good care of your child while he/she is with us. 

    If any information given here changes before the Venture begins please contact David White as a matter of priority; up-to-date information is vital

    All information on this form is essential and will be treated confidentially.

  • Date of birth*
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    2 digit month, 2 digit day, 4 digit year
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  • Emergency Contacts

    Please provide details of two responsible people (e.g. parent and grandparent) we can contact during the Venture. Please give two in case we are unable to reach one of them.

    It is vital that contact can be made in the case of accident or other emergency. Temporary overseas addresses are not acceptable; UK contacts only.

  • Emergency Contact 1

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  • Emergency Contact 2

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  • Details of your usual GP

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  • About the member

  • Height (if under 12 yrs old)*
  • Has your son/daughter been ill or in contact with an infectious or contagious disease, including diarrhoea and vomiting, conjunctivitis or been on antibiotic medication during the last THREE weeks?*

  • If you believe your son/daughter may have COVID, please do not send them to Bridgwater.

    For a full list of COVID-19 symptoms please visit the NHS website.

  • Is there any change to the health information you gave when booking?*

  • (E.g. recent injuries, new health problems or allergies, newly prescribed drugs)

  • Do you give consent for a responsible leader to dispense plasters and common over-the-counter medicines to your son/daughter with due diligence when appropriate?*

  • Such as paracetamol, Waspeze, antihistamine medication (e.g. Piriton tablets), hydrocortisone cream.

  • Is your son/daughter bringing any medication to the Venture?*

  • Please note that ALL medication, including inhalers, must be given to the Medical Officer on arrival so they can ensure proper supervision and also to protect other members on the Venture. Reliever inhalers will be given back to the individuals after this, but they must be declared at the start of the Venture.

     

  • Does your child need to keep their medication with them?*

  • If you have any queries, please contact the Bridgwater Overall Leaders.

  • Thank you for your help supplying this information for the Venture.

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