TCV Event: Welfare Form

First Name

Last Name

Email address

Emergency Contact: Name

Emergency Contact: Relationship to you

Emergency Contact: Phone

Do you have any physical or mental health conditions, illnesses or allergies we need to know about for this activity?

Are there any activities you may find difficult for health reasons?

If you require medical attention, your information may need to be shared with medical professionals. Do you consent to sharing your information for this purpose?

I understand that it is advisable to have protection against tetanus when working outdoors.

In order to celebrate the work of our volunteers we often take photographs of our activities. Are you happy for us to use photographs and video of you for the purposes of publicity and other reports?

I am involving myself of my own free will and declare that to the best of my knowledge the information given is correct and I know of no reason why I should not participate.

I consent to the personal details supplied on this form being used by TCV to ensure my safe welfare on the day and to share more information about this event.

Event Date: Saturday 23rd November 2019

Site: Westcroft Way Estate

Team Leader: Judith Ressler

Your Name

Emergency Contact Details

Your Health and Welfare

Tetanus

Photography

Declarations

Communications