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JUNIOR REGISTRATION

JUNIOR REGISTRATION FORM

Parent/Guardian Details


Junior Member #1 Details

Are you a new member?
YesNo
Gender:
MaleFemale
Emergency Medical Details
In an emergency, do you authorise EFLC to arrange any necessary medical treatment for the member, where contact with an emergency contact has not been possible?*
YesNo
Does the member have any medical conditions?*
YesNo

Does the member take any medication?*
YesNo

Does the member have any allergies?*
YesNo

Junior Member #2 Details

Are you a new member?
YesNo
Gender:
MaleFemale
Emergency Medical Details
In an emergency, do you authorise EFLC to arrange any necessary medical treatment for the member, where contact with an emergency contact has not been possible?*
YesNo
Does the member have any medical conditions?*
YesNo

Does the member take any medication?*
YesNo

Does the member have any allergies?*
YesNo

Junior Member #3 Details

Are you a new member?
YesNo
Gender:
MaleFemale
Emergency Medical Details
In an emergency, do you authorise EFLC to arrange any necessary medical treatment for the member, where contact with an emergency contact has not been possible?*
YesNo
Does the member have any medical conditions?*
YesNo

Does the member take any medication?*
YesNo

Does the member have any allergies?*
YesNo

Junior Member #4 Details

Are you a new member?
YesNo
Gender:
MaleFemale
Emergency Medical Details
In an emergency, do you authorise EFLC to arrange any necessary medical treatment for the member, where contact with an emergency contact has not been possible?*
YesNo
Does the member have any medical conditions?*
YesNo

Does the member take any medication?*
YesNo

Does the member have any allergies?*
YesNo

All registrants agree to the Consent to Take Photos.*

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EFLC Code of Conduct.

A copy of your responses will be emailed to the address you provided.

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