Forms home Duke of Edinburgh’s Award (DofE) expedition consent 1 Contact details2 Consent IMPORTANT – This form must be completed by the parent, guardian or carer if the participant is under 18 years of age and by the participant if over 18 years of age. Name of particpant First Last Address Street Address Address Line 2 City AberdeenshireAngus/ForfarshireArgyllshireAyrshireBanffshireBedfordshireBerkshireBerwickshireBlaenau GwentBridgendBuckinghamshireButeshireCaerphillyCaithnessCambridgeshireCardiffCarmarthenshireCeredigionCheshireClackmannanshireConwyCornwallCromartyshireCumberlandDenbighshireDerbyshireDevonDorsetDumfriesshireDunbartonshire/DumbartonshireDurhamEast Lothian/HaddingtonshireEssexFifeFlintshireGloucestershireGwyneddHampshireHerefordshireHertfordshireHuntingdonshireInverness-shireIsle of AngleseyKentKincardineshireKinross-shireKirkcudbrightshireLanarkshireLancashireLeicestershireLincolnshireLondonMerthyr TydfilMiddlesexMidlothian/EdinburghshireMonmouthshireMorayshireNairnshireNeath Port TalbotNewportNorfolkNorthamptonshireNorthumberlandNottinghamshireOrkneyOxfordshirePeeblesshirePembrokeshirePerthshirePowysRenfrewshireRhondda Cynon TaffRoss-shireRoxburghshireRutlandSelkirkshireShetlandShropshireSomersetStaffordshireStirlingshireSuffolkSurreySussexSutherlandSwanseaTorfaenVale of GlamorganWarwickshireWest Lothian/LinlithgowshireWestmorlandWigtownshireWiltshireWorcestershireWrexhamYorkshire County Postcode Home PhoneMobile(Required)Please re-enter mobile number(Required)Date of Birth Date Format: MM slash DD slash YYYY Emergency Contact - during the activity/trip(Required) Mum Dad Other Full name(Required) First Last Contact number(Required)Please re-enter contact number(Required)Second Emergency Contact - during the activity/trip Mum Dad Other Full name First Last Contact numberPlease re-enter contact numberIn the event of an emergency, every possible effort will be made to contact you. We request that you agree to the young person receiving medical treatment if the situation arises. It is important for you to understand that a doctor will make any decision about medical treatment. If you do not give consent, the young person will not be able to attend this activity. I agree to the young person receiving medical treatment in the event of an emergency or in a case where the leader deems the need to prevent unnecessary discomfort or future infection e.g. removal of ticks. Please give details of any medical condition e.g. allergies (general, or to medication, anaesthetics etc.) asthma, diabetes, epilepsy, etc.Please list any required medication Date of last tetanus injection Date Format: MM slash DD slash YYYY VenueDates I have ensured that the young person understands the information given, particularly that relating to the safety of the individual and of the group and that he/she understands the need to comply with any rules and/or instructions given by any of the activity/trip leaders and staff I undertake to inform the activity/trip leaders of any changes in the fitness of the young person prior to the date of departure I agree and understand that Redbridge Youth Service can share the participant’s personal information with the Managers of Redbridge Youth Service and expedition leaders and Mangers of Mud and Maps to enable them to contact you in an emergency I agree and understand that Redbridge Youth Service can share the participant’s medical information with the Managers of Redbridge Youth Service and expedition leaders and Mud and Maps. I confirm that those in charge of the expedition may give permission for the young person to receive medical treatment in an emergency I agree to the young person being in photographs or videos of this venture, which may be later used for display purposes or the end of expedition presentation for the other young people in their group I confirm that the young person will eat and drink during the expedition. If the leaders become aware that the young person is not eating and drinking to a safe and healthy level, they will not be able to continue. You will be contacted and you will be expected to collect the young person and take them home I understand that staff are not able to give young people medication, this includes headache tablets. If young people bring their own headache tablets or other non-prescribed medication, they must tell the leaders that they feel unwell before they take the tablets and must not give tablets to other young people I agree that the cost of the expedition is non-refundable unless cancelled due to COVID restrictions issued by the Government or London Borough of Redbridge. If this happens, the expedition will be rearranged and you will be offered the opportunity to transfer the booking to the new date Consent of adult(Required) I confirm my understanding of all arrangements as set out and consent to the young person in my care taking partEmail Please state your name and relationship to the young personConsent of young person(Required) I understand that for the groups and my own safety, I will undertake to obey the rules and instructions of the activity/trip leaders and other members of staff during the trip.Date Date Format: MM slash DD slash YYYY Terms and Conditions(Required) I have read and agree to the terms and conditions.