Adult Medical & Emergency Contact Form 2025
Please fill in your details.
Full Name
I understand that I will be taking part in high risk adventurous activities which could involve water sports eg. kayaking, rafting & raft building; mountain activities, including walking, scrambling, indoor and outdoor rock climbing & mountain biking
I confirm that I am physically competent to take part in all activities.
Are you able to swim 50 metres?
Select an option
Yes
No
Please give details of any medical conditions/ medication / additional needs of which the activity leader needs to be aware
Emergency contact details:
Relationship to you
Emergency contact number
I agree to being photographed during activities.
Select an option
Yes
No
I give permission for photos/ videos of myself to be used to publicise WAVE Adventure and/or appear on media sites.
Select an option
Yes
No
Submit
Powered by