PDB test page – Blackheath Fencing Club

Contact Details Please enter YOUR name and contact details. For Musketeers (15 or under) the contact details, should be that of a parent or guardian. Please enter the other parent's name and details in the Medical and Emergency Contact section. Items with * are required
First Name*	YOUR name ie Adult or Parent
Family Name*	YOUR family name ie adult or Parent
Address*
Local Borough Council*	All the surrounding London Boroughs are listed
County*
PostCode*
Email*	We will use this to send you information about term dates, events you may be interested in and urgent information
Your email again please*
Mobile phone*	Must be that of a person 16 yrs or over. We will only contact you if absolutely necessary
Home phone	Only if you have a home landline
Fencer's details About the fencer
Fencer's First Name*	If you are an adult enter the same as previous tab. If a parent then enter your child's name
Fencer's Family Name*	If you are an adult enter the same as previous tab. If a parent then enter your child's name
Gender*	GenderMF
Date Of Birth*
Date Joined	eg Start date of taster/course or first day at the club.
Student 18+, Unwaged or Retired?*	Student 18+, Unwaged or Retired?YesNo Concession rates may apply
Concession Reason
Ethnicity*	Required by the Race Discrimination Act 1976 and uses the categories it defines
About your fencing Please tell us what are you interested in
Novice Training*	Novice TrainingYesNo Training and Tasters for ages 16 to 60. No experience required
Junior fencing*	Junior fencingYesNo Ages 9 to 15
Adult membership*	Adult membershipYesNo For experienced fencers only
Days*	DaysTueThu Which day(s) would you be interested in? Note: Musketeers (U16) are Tuesdays Only
Weapons	If you already fence what are your preferred weapons in order of choice eg Foil, Sabre, Epee. Use = for equal choice eg foil epee=sabre
Hand*	HandRightLeftEitherNot sure! Which is your dominant hand?
Previous Experience	Do you or your child have any previous fencing or sport experience?
Fencing Objective*	Fencing ObjectiveExerciseCompetingSocialCurious other: What is it about fencing that interests you?
BF Membership No	British Fencing Membership Number. Membership is required. NB. Adult trainees require Introductory Membership. Scroll up to the menu and select British Fencing Membership under The Club. Follow the instructions. You will return here.
Medical, Emergency & Parent contacts Please advise any issues that may affect the fencer and might become apparent while fencing. eg Diabetes, asthma, epilepsy, epipen user, heart condition, etc., we really need to know! Knowing about learning or behavioural issues helps us understand and integrate a child but providing this is entirely voluntary. All information will be kept confidential and only shared with the Coaches, Club Officers and the emergency services
Do you consider you/your child to have a disability(1) or medical condition?*	Do you consider you/your child to have a disability(1) or medical condition?YesNo (1)Defined by the Disability Discrimination Act 1995: "A physical or mental long term impairment which has substantial long term adverse effect on ability to carry out normal day to day activities"
Medical Status	Medical StatusNoneVisual ImpairmentHearing ImpairmentPhysical DisabilityLearningBehaviouralMultiple other: Anything we should be aware of eg the nature of the disability or medical condition
Emergency Contact*	Name and phone of partner, carer, doctor, friend, specialist, etc.
Confirmation and Consents Here you will confirm how we can contact you and that you have read the Privacy Statement, Risk Statement, T&Cs and, for parents, the Child Protection Policy and Codes of Conduct in the Parents Pack.
Contact Preference*	Contact PreferenceWhatsAppEmailTextMsg What is the best way to reach you? You will be invited to join a WhatsApp group which provides immediate notices of class status, reminders, lets you notify us of delays, ask questions, etc..
Data Protection*	You have read and agree to the Privacy Statement
Child Protection*	Child ProtectionYesNoN/A Parents and Carers: You have read and agree to the child protection policy and codes of conduct? ClubMark
Child Medical*	Child MedicalYesNoN/A Parents/Carers You agree to grant 'in loco parentis' (as a parent) rights to qualified first aiders to provide medical treatment and transport to hospital if required
Home Alone*	Home AloneYesNoN/A You consent to letting your child go home alone. Only permitted for ages 14 and above
How did you find the Club?	How did you find the Club?British FencingFriendPoster/LeafletSocial MediaInternet Search other: Other = eg walk by,
Would you like to help at the club?*	Would you like to help at the club?YesNoPerhaps There are a number of ways members, parents and carers can assist. Say Yes and we will let you know more!
Prove you are human!*	6 + 9 = ?

	October 2021
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18	19	20	21	22	23	24 LR intermediate comp LR intermediate comp 23/10/2021 St Benedict's School - Sports Hall, 16 Marchwood Cres, London W5 2DZ, UK Welcome Back N&I 2021 – London Region Fencing See more details •
25	26 Adult Members ONLY Adult Members ONLY 25/10/2021 There will be no Musketeers or Adult Training course this week See more details Refresh Training for 2020 trainees Refresh Training for 2020 trainees 25/10/2021 See more details • •	27	28	29	30	31

Contact Details

Fencer's details

About your fencing

Medical, Emergency & Parent contacts

Confirmation and Consents