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CAMBRIDGE UNIVERSITY LION DANCE TROUPE MEMBERSHIP FORM

By Marilyn Diaz,2014-12-08 10:35
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CAMBRIDGE UNIVERSITY LION DANCE TROUPE MEMBERSHIP FORM

    CAMBRIDGE UNIVERSITY LION DANCE TROUPE

    MEMBERSHIP FORM

Full Name: Date of Birth:

Email: College:

Telephone No:

In case of emergencies-

Primary Contact Name:

Primary Contact Address

Telephone No:

    Please state below any relevant medical information. This should include: •Any medication taken, including details of what, when and how much

    •Any know allergies

    •Information on conditions such as diabetes, epilepsy, asthma

    •Any recurring injuries/ailments (e.g. back problems, dislocating shoulders)

    Please read the following carefully and sign to state that you have read, understood and agree to it. Feel free to discuss any concerns with a Committee member:

    1. Session coaches may prevent you from training or performing if they

    deem you physically/mentally unfit to do so.

    2. I permit the troupe committee to hold this form on file and to use the

    information on it as required in discharging their responsibilities.

    3. I understand that the activities undertaken by Cambridge University Lion

    Dance Troupe carry an element of risk, including the risk of injury and

    death. I understand that I must make my own decisions about participation

    in any activity and am empowered to ask questions if in doubt about the

    nature or risks inherent in any activity.

    4. I indemnify the Cambridge University Lion Dance Troupe of any

    responsibility in case of any injury/death caused during training/

    performances due to accidents or due to personal neglect on my part.

Signature: Date:

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