ENGLAND HOCKEY CONSENT FORM
This form must be completed by all under18 persons participating in any course provided by
England Hockey (EH) and MUST be co-signed by a parent or person with legal responsibility. It
represents authorisation for you to participate in all EH activities, both on-site and at various
sporting venues. You will not be able to participate in any activities without returning the form.
Please return this form to [email protected] or to Umpiring Administrator,
England Hockey , Bisham Abbey National Sports Centre, Marlow, Bucks, SL7 1RR.
Course Venue and Date
Full name of participant
DOB
Name of emergency contact
Emergency contact numbers
Relationship
Mobile
Home
PHOTOGRAPHY/RECORDED IMAGE CONSENT
To be completed by the participant and the parent.
There are likely to be photographs taken at EH events. EH may use the photographs for
promotional material and also as video evidence for feedback purposes and coaching opportunities.
All filming and still shot photography will be captured and used in accordance with the England
Hockey Photography Policy (most notably, no personal identification will be labelled to any photos
or film).
It is a requirement of the EH Child Protection Policy that the consent of parents/ those legally
responsible and the young person is obtained prior to taking photos or filming. Please complete the
form below and return it to us. Thank you.
(name of participant) give England Hockey permission to hold my
I
I do/do not* authorise EH personal
to use thedetails.
images resulting from any photo/film shoot. This includes any
reproductions or adaptation of the images for all general publicity purposes.
Signed
Date
am the parent / person with legal responsibility * of the above and have full
I
of their action in regard toknowledge
this form. I do/do not* authorise EH to use the images resulting from any
photo/film
shoot.
This
includes
any reproductions or adaptation of the images for all general publicity purposes.
Signed
* Please delete as appropriate
EHB Consent Form – November 2010
Date