Click here for Word Document version of this form

Please Note: Post December 2003 current details updated on BJA Website

Cadet Information Home Page.

The British Judo Association

Boys Cadet Squad 2003.

CONSENT FORM- SQUAD MEMBERS.

 I hereby authorise the Representative of the British Judo Association, Cadet Boys

Squad to act on my behalf in the event of my son requiring treatment due to injury or

illness sustained in my absence, further to act on my behalf if my son is selected for a

Random Drug Test at International Competitions, Squads or other such events. **

Name:…………………………………..               Date of Birth:………………………...               

Address:…………………………………             Postal Code:………………………….

……………………………………….......             Telephone No…………………………           

…………………………………………...

Signed:…………………………………..             Parent / Guardian

MEDICAL DETAILS.

Family Doctor:……………………….…                        Date:………………………………….           

 
Addres………………………………….. …                     Telephone No:………………………

……………………………………………..

……………………………………………                         Post Code: ……………………………

Please list any known allergies or long — term medication (This information will

Only be revealed to the appropriate medical personnel when necessary)

Please return when completed to:

Trevor Sitlinton

187 Dewsbuiy Road

Leeds 11

LSJJ SEH- Yorkshire

** IT IS ESSENTIAL THAT ONCE COMPLETED, THIS FORM IS RETURNED TO THE ABOVE PERSON - FURTHER IF WE ARE NOT IN POSSESSION OF THIS DOCUMENT YOU WILL NOT BE ALLOWED TO TRAVEL & COMPETE

Can you please attach a completed Elll Medical form with this document when you

Return it. (The E11‘s are Medical Insurance forms used whilst travelling within the

European Community and are obtained from the Post Office and must he filled in and

Stamped)

National CC form.