Medical Declaration - Group {{formidable-field-id-22}}

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Booking ID
Date of Event
Booked By
Name of School / Group Name
Name of Principal or Supervising Teacher or leader
Teacher/Parent Name
Your Email
Your Phone Number
How will the medical declaration cover your group?
Who is covered by this medical declaration

Please outline if any members of your group have/require any of the following:


I, group leader of the above group / organisation confirm the participants attending are fit and able to participate in all the activities on their itinerary. I understand the activities they are participating in, at Cuskinny Court Group Activity Centre, have a number of inherent risks & hazards that are beyond the control of the operator and its staff. I agree to personally assume this risk, in the knowledge that the operator will take every care within their responsibility to protect and maintain health and safety. I sign this consent agreement of my own free will and agree to their terms and conditions.

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Signature Certificate
Document name: Medical Declaration - Group {{formidable-field-id-22}}
lock iconUnique Document ID: bbfacd6ae16a00c4edb1fc12ff7973dad84dca8b
Timestamp Audit
30th March 2023 9:37 am ISTMedical Declaration - Group {{formidable-field-id-22}} Uploaded by Cuskinny Court - IP