CAMBRIDGE UNIVERSITY LION DANCE TROUPE
Full Name: Date of Birth:
In case of emergencies-
Primary Contact Name:
Primary Contact Address
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.