GHC Inmaculada 2018 Tour

Form 1: Player Details and Consent

Please complete the details and consent form for your player - you will need your player's passport and EHIC details. Please note the comments in the grey boxes for guidance and the format for the required dates.

GHC Squad:*

Player LAST Name:*

Player FIRST and MIDDLE Names:*
	Player FIRST and MIDDLE names must be all names AS THEY APPEAR ON YOUR PASSPORT

Title:*

Passport Number:*

Date of Birth:*
	This must be in the format DDMMMYYYY for the airline API with D and Y as numbers and MMM as letters - 20/02/1980 should be entered as 20Feb1980

Document Expiry Date:*
	This must be in the format DDMMMYYYY for the airline API with D and Y as numbers and MMM as letters - 15/04/2020 needs to be entered as 15Apr2020

Gender:*

EHIC Personal Identification Number:
	The number that starts with UK...

EHIC Card Number:
	The 10 digit number after 80826 00001

Medical Needs Including Medicines:*

Dietary Requirements:*

Allergies:*

Contagious or Infectious Diseases:*

Date of Last Tetanus Injection:*

Parent email address for Tour communications:*

Parent also on Tour - please specify mum, dad, both:*

Parent Phone Number During Tour:*

Additional Contact During Tour - Name:*

Additional Contact During Tour - Phone Number:*

Name of Person Giving Consent and Relationship to Player:*

Consent Statement:*
	I have read the instructions and description of the tour and consent to my child taking part. I accept that hockey is a contact sport and that minor injuries can occur. My child will be responsible for wearing suitable shoes, shin pads and a gum shield at all times when on the field of play and will wear face protection (provided) and cricket box (not provided) to defend short corners. I acknowledge that Coaches will refuse to allow a player on the pitch if he or she does not have adequate protection for the standard of game being played. I agree to my child receiving every medical, dental and surgical treatment deemed necessary by the medical and other qualified personnel advising at the time, including blood transfusions and anaesthetics. I understand that the club will try to contact me immediately in any such event, but that in an emergency, decisions may need to be taken in my absence.

Consent:*

	yes
	no

Enter not this field:

*Indicates a field you must enter.

When you have completed the above fields, please click the Send Details button ONCE to send.