Waiver/Temporary Membership Form

This form needs to be completed by every skater or their appropriate adult, where under 16, it needs to be filled in every academic year to ensure we have up to date infomation.

We (Volunteers in Blue tshirts/hoodies) get you to sign this so that you appreciate that skating can be dangerous, also, if there is a medical issue we hve access to your address and NoK details to contact you if you are not in the hall. We do not have specific conduct rules but ask each skater to practice in a safe manner so that everyone can enjoy the session. We will approach skaters we feel need extra support or reminding of the be safe for everyone environment we all wish to skate in.

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First name of skater

Last name of skater

Address and postcode of skater

Skaters Date of Birth

Day

Month

Year

Are there any medical conditions of the Skater that may affect sport participation?

Yes/No

If yes please provide details

Please list any Medications (relevant to participation)

Name and relationship to skater if under 18

Address of parent/carer where different and skater is under 18

Phone number

Email address

I hereby give consent for the above named Skater to particpate in the sport of Artistic Roller Skating.

I understand that, as with any sport, there is risk of inury and participate willingly knowing this.

I hereby give consent for the above named skater to receive First Aid treatment, if required.

I understand that The Federation Of Artistic Roller Skating require all children under 10 to wear protective equipment.

This is a I understand that I take full responsibility for my child to skate, and that the choice to not wear protective safety equpment

Signature of skater or parent/guardian if skater is under 18

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