Indemnity Form

Participant Details

If the participant is a minor, please input the best contact email address for the participant whether that is their own or a parent/guardian


Please let us know of any medical conditions you think we need to know

Please use this box to let us know if there is anything else you would like us to know. For those attending a residential activity, please use this box to let us know of any dietary requirements.

Emergency Contact Details

By signing this agreement I confirm that I have disclosed all medical conditions, I will wear an appropriate buoyancy aid and any safety equipment that has been issued at all times when on the water & follow instructions given by the Andrew Simpson Centre Team. Although I am covered for 3rd party liability by Andrew Simpson Centre insurers, I understand that owing to the nature of the sporting activity, the Andrew Simpson Centre Team cannot take any liability for personal injury or other damages unless proved negligent.