Consent Form

Please complete this consent form prior to attending a course

The following information is confidential, it will be retained securely and not shared with third parties without your express consent. Please fully complete this form prior to attending a course

Please let me know which course you're attending
Note a copy of your forms submission will be emailed to you if you provide an email address here.

Statement of participation

The activities we are undertaking are hazardous activity. All efforts will be made to minimize our exposure to hazards however some such as radon are unavoidable, and accidents do happen. Personal accident insurance should be considered. Participants must be aware and accept the risks associated with this activity. Any medical or other factors that may affect your performance during the activity must be highlighted to me prior to the session. If using your own/own Centre/Providers personal protective equipment, you do so at your own risk and must be confident that it’s fit for purpose.

For those attending a Cave and/or Mine Leader training or assessment courses to get the most out of the courses please be prepared to venture into areas that may be beyond the remit of the award. Attendance on this course assumes that you are physically capable and comfortable exploring underground, aware of the hazards and except the risks associated to exploring underground.

Your personal data will be held securely as evidence of your participation in this course indefinitely, it will not be shared with third parties or used for marketing purposes without your consent. Please confirm you have read and understood these notes below.

Medical/Fitness Declaration

Please outline any medical or other considerations that we need to be aware of prior to you attending this course.

Photo/Video consent

During your course there may be opportunities to take photos/videos. The main aim of this is to provide a resource to help support your learning, although may also be used for various publicity purposes

Please confirm if you're happy for photographs and videos to be taken of you during the course

Are you happy for photos/videos to be used for the following

COVID-19

Please confirm, by ticking the boxes below, that you will not attend this course should you develop any of the symptoms outlined below.

Please also confirm you understand the measures we will need to take to ensure we are as safe as reasonably practicable prior to attending the course

Note should you not be able to attend this course due to COVID you will be offered a full refund or a place on the next course

Agree that you will not attend this course if any of the following apply to you *
Please tick to confirm you understand and will follow the guidelines listed below during the course