2019 UK Chinese Dragon Boat Festival

Crew Member Personal Health and Safety Register Form

Part 1: Personal Information

Title*

First name*

Surname*

Gender*

Mobile*

Email*

Team*

GPs Health Centre:*

Next of Kin*

Emergency Contact Number*

Height*

Weight*


Part 2: Medical History

1.Please tick if it applies


Part 3: Event Safety
  • 1. Event safety – swimming.

    I declared competent in deep water and capable of swimming 50 metres with the aid of an approved personal flotation device (buoyancy aid). Such buoyancy aids will be provided by the event’s organisers for competitors use whilst on the water.

  • 2. Special Needs / Disabled.

    As a team member(s) I understand if I am either disabled or ‘having special needs’, then for safety reasons I must inform the boat’s helm prior to each race.

  • 3. Minimum Age requirement.

    In the interests of safety I understand a minimum age of sixteen years old is set for competitors.

  • 4. Event safety – swimming

    I understand I must ask the event’s representative prior to undertaking the training and race programme if I am a weak swimmer, non-swimmer, or have a medical condition that might affect the safety or performance on the water. Such conditions might include but are not limited to:

    • a) Suffer from chest pains or shortness of breath
    • b) Have been told by their Doctor that they have heart trouble
    • c) Have been told that their blood pressure is too high or too low
    • d) Have fainting or dizzy spells
    • e) Have undergone a recent operation
    • f) Suffer from bone or joint problems i.e. arthritis, spinal injury etc
    • g) There is any other reason why they should not participate in an exercise programme, which in the case of Dragon Boat Racing should not exceed 2 minutes of active aerobic exercise per race.
Part 4: DECLARATION OF FITNESS TO COMPETE

I hereby declare that I have read and understood all the questions in this registration and shall bear all the legal consequences for the authenticity of the information I provided.