Programme Consent Form


Programme Information

Programme Start Date (Please enter as DD/MM/YYYY):
 

Level of award:

 

Contact Information

Name of participant:

 

You are joining Adventure Expeditions & Adventure Expertise (AE):


 

Please enter the name of your School/Group/Business. If on an open programme, please type ‘Open’

 

Participant DoB (Please enter as DD/MM/YYYY):

 

Medical Information

In order to attend a programme with AE, all participants are required to detail any medical conditions, illnesses and injuries (recent, historic, sporting or otherwise), allergies, medications taken or that may be needed while with us or any other details that may affect them during their programme. This information is collected either at the time of booking or on a separate information/consent form following booking.

If any medical information changes between completing a booking/information/consent form and any of your programmes with AE commencing, it is your responsibility to inform us immediately – please email details over to [email protected] or call us on 01433 651449 to discuss.

Full medical information is required in advance so that we can make any preparations to support you throughout your programme – we are supportive and have experience of working with a wide range of medical conditions and differing needs but can only provide you with a safe, high quality experience if we have information in advance.

 

Photographs & Video

Adventure Expeditions (AE) may take photographs and/or video footage of you during your expedition. We aim to make a copy of the photographs and videos taken available to you as a memento of your expedition and for use in your DofE Keeping Track portfolio on eDofE. We may also use footage and images to promote our activities (printed and internet publications).

Please indicate your preferences below:

 

Protection of your data

Adventure Expeditions (AE) handles all participant data in accordance with GDPR 2018 and the Data Protection Act 2018. AE only uses your data for the purposes of administrating and delivering training, expeditions and outdoor programmes. Therefore, your data is only used by those acting on behalf of AE and any other awarding body involved (E.g. The Duke of Edinburgh’s Award, Mountain Training, the school or business you are joining us through).

By signing an AE Consent Form you are confirming that you are happy for us to use your personal data in this way. Data will be kept in line with the Limitation Act 1980. Adventure Expeditions and Adventure Expertise are both registered with the Information Commissioner’s Office (ICO) and you can contact the ICO if you have any issues with the way AE handles your data. If you have any questions, please email or call: [email protected] or 01433 651449 and speak to AE’s Data Manager.

 

Acknowledgement of Risk

We have taken all reasonable steps to provide participants with the level of care and assurances of safety appropriate to the activity. However, there are certain risks which are integral to the activity and which cannot be eliminated without destroying the unique character of a Duke of Edinburgh’s Award or International Award Expedition.

DofE Expeditions must be unaccompanied, self-reliant and completely by the participants own physical efforts with minimal external intervention. Therefore, participants will not be directly supervised 100% of the time. During the expedition you may encounter the following:

  • Walking on rough terrain;
  • Extended physical effort;
  • Environment hazards (changeable weather and terrain, etc);
  • Feeling uncomfortable, tired and upset.

 

Medical Statement

In the event of an accident or incident, I give my consent to any emergency treatment as considered necessary by the medical authorities present. I therefore authorise AE and any AE instructor(s) present to sign on my behalf, any written form of consent required, provided that in the opinion of the doctor/surgeon any delay could endanger the health and safety of the participant.

 

Agreement

I wish to take part in the Duke of Edinburgh’s Award / International Award training and expeditions provided by Adventure Expeditions. I confirm that I am fit and able to undertake an expedition where I will be walking for extended periods of time in mountainous or hilly terrain, whilst carrying all necessary expedition kit.

I agree to follow the instructions of Adventure Expeditions. I understand that I will need to work as part of a team and agree to show respect to my fellow participants at all times.

I confirm that I have read and understood the contents of this document and I understand what I will be participating in.  If I have questions I will email AE for clarification: [email protected]

I confirm that I will immediately inform you if there are any changes to the above medical information supplied prior to the expedition.

By signing this you do not release Adventure Expeditions from any of their obligations, nor does it affect your legal rights.

 

Signature

 

If you are over 18 at the time of signing this form – please complete the signature box below.

 

If you are under 18 at the time of signing this form – a parent/guardian will need to sign this form on your behalf. As the participant on the programme, please print your name in the box below to confirm that you have read and understood the contents of this Consent Form:

 

Participant Name:

 

Date:
20th November 2018

 

Parents / Guardians – if you are signing this form on behalf of a participant who is under the age of 18 at today’s date, by doing so you are confirming that you have read and explained the contents of this form to the participant. Please give your details below – NB we may contact you to verify details contained in this form if necessary:

Parent/Guardian Name:

 

Contact Telephone Number:

Leave this empty:

Adventure Expeditions https://adventure-expeditions.net
Signature Certificate
Document name: Programme Consent Form
Unique Document ID: 7e8155433b7a7cebf65e2cc62a943407eeae5678
Timestamp Audit
29th June 2018 3:04 pm GMTProgramme Consent Form Uploaded by Cat Freeman - [email protected] IP 88.215.45.30
30th August 2018 11:23 pm GMT Document owner [email protected] has handed over this document to [email protected] 2018-08-30 23:23:36 - 86.28.126.88