Volunteer Next of Kin Details

The following information is required by the WMF committee as part of its commitment to protecting the health and welfare of its volunteers during the festival which is taking place 14-16 September 2018. All information will be treated in the strictest confidence and WMF confirm adherence to the provisions of the GDPR Regulations 2018. Information will be held securely by the WMF committee and will only be accessed in the event of an emergency situation. Medical information may be shared with third parties (i.e. paramedics) if this is appropriate.

All data will be destroyed within one month of the end of the festival.

Form

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About You

Name:*

Email:*

Phone:*

Date of Birth:*

Age:*

Address:*

(Please give details of any unspent criminal convictions, which may be considered as relevant to the placement. If none, please write NONE)

Criminal Convictions:*

Next of Kin Details:

Who should be contacted in an emergency

Name 1:*

Relationship to you:*

Contact number:*

Name 2:

Relationship to you

Contact number

Medical History

GP Name:*

GP Telephone:*

GP Surgery Address:*

Please give details of any medical conditions, diseases, disorders, allergies and any medication taken. If none, please write NONE)

Medical Information:*

I understand that WMF reserves the right to terminate this placement in the event that the information provided above is inaccurate in some material way. I confirm that, to the best of my knowledge, the information given in this form is true. I give my consent for this information to be shared with relevant members of the WMF committee and for my medical details to be shared with any Duty First Aiders and/or emergency services.

I confirm and agree*

Please enter the characters you see above*