Winter Sports Tour Health Declaration Form
Full Name
Date of Birth
Home Address
Email
Phone Number
Emergency Contact
Contact Name
Phone Number
Medical Information
Existing Medical Conditions
Allergies (inc. food, medication, etc.)
Current Medications
Family Doctor / Clinic
Doctor Contact Number
Fitness & Consent
I confirm I am physically fit to participate in winter sports activities.
I am not suffering from any injury or illness that may affect my participation.
COVID-19
I have not experienced any COVID-19 symptoms or been in contact with a confirmed case recently.
Declaration
I declare that the above information is accurate and complete.
Signature
Date