Elysian Activity and Consent Form (Consent Pack Part 2)

Participant Name

First

Last

Date of Birth

Parent/Carer Name (if participant is under 18)

First

Last

Email Address

Activity Consent

I understand that participation in Elysian activities involves inherent risks, including working around horses, farm animals, outdoor environments and equipment.
I understand that horses and other animals can behave unpredictably and may kick, bite, push, pull, scratch or otherwise cause injury despite appropriate supervision.
I understand that all instructions given by Elysian staff and volunteers are provided for health and safety reasons and agree that they must be followed at all times.
I understand that appropriate clothing and safety equipment must be worn for relevant activities.
I understand that I am responsible for ensuring the participant arrives appropriately dressed and equipped for the activities they are attending, and that failure to do so may mean they are unable to participate.
I understand that riding hats are compulsory when riding unless otherwise instructed by Elysian staff.
I understand that body protectors may be recommended or required depending on the activity.
I understand that Elysian will make decisions about participation based upon the information I have provided regarding health, behaviour, confidence, communication and support needs.
I agree to inform Elysian immediately if there are any changes to medical conditions, medication, allergies or support needs.
I understand that Elysian may refuse, postpone or stop participation in any activity where this is necessary for safety, welfare or operational reasons.
I understand that participation is subject to suitability and safe behaviour.

Please describe any previous experience relevant to the activities being attended.

Are there any fears, concerns or anything we should know to help make participation enjoyable and safe?

Food Consent

I give permission for the participant to receive drinks and light refreshments provided by Elysian where appropriate.
I confirm that I have informed Elysian of any allergies, intolerances or dietary requirements.
I understand it is my responsibility to notify Elysian if these change.

Information Sharing Consent

I consent to Elysian sharing relevant information with healthcare professionals, education providers, local authorities or other appropriate professionals where necessary to support safe participation, safeguarding or wellbeing.

Please tell us if there is anyone you do not wish Elysian to share information with.

Photography & Media Consent: Internal records

Yes
No

Photography & Media Consent: Displays within Elysian

Yes
No

Photography & Media Consent: Printed publicity

Yes
No

Photography & Media Consent: Website

Yes
No

Birth with. of

Photography & Media Consent: Social media

Yes
No

Photography & Media Consent: Marketing materials

Yes
No

Code of Conduct

I confirm that I have read, understood and agree to follow Elysian’s Code of Conduct and any instructions given by Elysian staff.

Final Declaration

I confirm the information provided is accurate.
I understand that participation in Elysian activities involves managed risks.
I understand that Elysian may refuse participation if it is considered unsafe.
I understand that consent may be withdrawn at any time by contacting Elysian.

Name of person completing the form

First

Last

Relationship to participant

Digital signature

Clear Signature

Date