Name of school and year

What is your ELA membership number?

I consider myself/the player to be physically fit and capable of full participation and agree to notify Reigate Priory Lacrosse Club of any changes to the medical information provided. Furthermore, in the event of injury I give my permission for her to be provided with emergency medical treatment by the team manager/coach appointed by Reigate Priory Lacrosse Club.
Agree to this declaration :

For minors, to be answered by parent or legal guardian:
It is a requirement of Reigate Priory Lacrosse Club policy that parental/legal guardian consent is provided for participation, transportation and photography. The Reigate Priory Lacrosse Club Members' Code of Conduct and Safeguarding and Protecting Young People Policy are available from the club. Please read the consent below and then indicate your agreement.

Transportation: I consent to the player travelling to venues for matches and training, which may include travelling in other players’ private cars.
Photography: In some environments, it is impossible to control photography by external parties. However, I am aware that there may be times that photographs and/or footage may be taken during matches and training sessions by approved agents and/or officers of Reigate Priory Lacrosse Club. Such images shall only be used for publicity/training purposes in accordance with the Reigate Priory Lacrosse Club Members' Code of Conduct and Safeguarding and Protecting Young People Policy and I give consent for the player to feature in such photos/images. I hereby only grant approved agents the rights to use the images resulting from the photos/film shoots. This includes any reproductions or adaptations of the images for all general purposes, eg local newspapers, magazines, other promotional materials and the club’s website.
Data protection: I consent to the personal data in this form being used only for the purposes of supporting the club’s activities of aiding regular communications (for example weekly newsletters) and awareness of any medical conditions. The data is stored securely by the club for the duration of the season and is deleted at the start of the following season. Data may be reviewed at any point and updated or deleted, where necessary (for instance change of home address). The data is not processed or viewed by any third party outside of the club.

Agree to this declaration :