— sl ell - PERSON CONSENT FORM (over 18s) NAME: Sarue DATE OF BIRTH: Seles O//44 | | EMAILADDRESS: S—== gn 7) D GTINTER MET Con PHONE NO: org _ EMERGENCY CONTACT DETAILS: ar gape Tesi SkEZ Ss MEDICAL INFORMATION ANY ALLERGIES: ANY SIGNIFICANT MEDICAL/PERSONAL INFORMATION: Doctor surceRy: “Foo Loo9e MS. DECLARATION: 1. l agree to participate in the activity and | am over 18 years of age. 2. lagree that | am fit to participate and know of no medical reasons or other reasons why | should not participate. 3. I consent to any emergency medical treatment that may be necessary if the emergency contact cannot be contacted. 4. | understand that | am taking part in this activity at ray own risk. 5. | agree to comply with my activity provider's instructions whilst carrying out the activity. 6. | accept that Weston College/... held responsible for any injury, loss or damage to my property or nivse'! during the activity. wit not bePERSON CONSENT FORM (over 18s) Pe DATE OF BIRTH: EMAIL ADDRESS: leileyloct 41 i@ icleucl cen BHONENG: EMERGENCY CONTACT DETAILS: OF1923 14 S49 MEDICAL INFORMATION ANY ALLERGIES: “le ANY SIGNIFICANT MEDICAL/PERSONAL INFORMATION: a [DOCTOR SURGERY: DECLARATION: 1. lagree to participate in the activity and | am over 18 years of age. 2. lagree that | am fit to participate and know of no medical reasons or other reasons why | should not participate. 3. I consent to any emergency medical treatment that may be necessary if the emergency contact cannot be contacted. 4. | understand that | am taking part in this activity at my own risk. 5. lagree to comply with my activity provider’s instructions whilst carrying out the activity. 6. | accept that Weston College/.... .. Will not be held responsible for any injury, loss or damage to my property or myself during the activity.ee rapeea Hee 6. Vaccept that Weston College/. held responsible for any injury, during the activity. w« Will not be loss or damage to my property or myself \ ive permission for any photographs or filmed footage of me to be used by Weston College Media Department for publicity material. 8. Ihereby give Weston College my permission to license any images/filmed footage of me and use them in any Media and for any Purpose (except pornographic or defamatory) which may include, among others, advertising, promotion, Marketing and packaging for any Product or service. | agree that the images/filmed footage of me may be combined with other images, text and graphics, and cropped, altered or modified as needed. General Data Protection Regulation The content we are Capturing will be used by Weston College Group for educational Purposes only and/or promotional marketing material for the college. By signing this document | agree for the Weston College Group to licence the content and use the image/video taken, my name and (if applicable) any agreed testimonial for the duration in the following (tick all that apply): Prospectus (2 years) i a Posters (3 years) Q Website (5 years) & Social Media (permanently) Film (5 years) & Adverts (3 years) a Banners (5 years) a News and PR (permanently) (J All of the above a Signature: JBarnard Date: 01/11/202385) PERSON CONSENT FORM (over ) NAME: Jodi Barnard EMAIL ADDRESS: jodi.barnard@kcl.ac.uk NCY CONTACT PHONE No: 07805192361 EMERGE DETAILS: n/a MEDICAL INFORMATION ANY ALLERGIES: n/a ANY SIGNIFICANT MEDICAL/PERSONAL. INFORMATION: n/a DOCTOR SURGERY: n/a DECLARATION: 1. agree to participate in the activity and | am over 18 years of age. 2. lagree that | am fit to participate and know of no medical reasons or other reasons why | should not participate. 3. I consent to any emergency medical treatment that may be necessary if the emergency contact cannot be contacted. 4. understand that | am taking part in this activity at my own risk. 5. | agree to comply with my activity provider's instructions whilst carrying out the activity.