Attendee 1 Details

Name *

Date of Birth *

Gender * Female
Male
Prefer not to say

Does the Attendee have any allergies? * Yes
No

Please provide details of any allergies

Please provide any other medical conditions and coping strategies

Please provide details of any medication provided with attendee

Dietary requirements including; No dairy, gluten, nuts or any other allergens

Any other information we should know about?

Attendees Address and Post Code *

Emergency Contact Name *

Emergency Contact Number *

Declaration: the participant agrees to follow the directions of the CST group leaders, instructors and coaches and will always demonstrate reasonable behaviour towards their own and other’s safety. They understand that CST may exclude any person acting against its interests. * Yes

Declaration: I consent to the participant taking part in canoe or paddle sports activities with the Canoe Sports Trust. They are water confident in light coating clothing and have no undisclosed medical conditions that might endanger themselves or others. I will inform the Base Supervisor or Activity Leader, on arrival, of any change to the above medical conditions. * Yes

Declaration: I accept the CST registration terms that are available on request. Yes

Declaration: I have read “About Blue Green Algae” and confirm my willingness for this attendee to participate in activities in water that may contain blue green algae. Yes

About Blue Green Algae