HKPC Medical Consent Form

Hong Kong Pony Club Medical Consent Form

General Camp and Activity Medical Release
1 September 2019 - 31 August 2020
Name of Child *

First Name Last Name
Parent Email *
example@example.com
HKID number or passport number of participant *
Please put in the following format: A123456(7)
Does the child have any allergies? *

YES (please give details) NO
Allergies (if any)
Type of Allergy
Medications and other precautions (if any)
Please give as much detail as possible
1st Contact in case of EMERGENCY *

First Name Last Name
Phone Number *
2nd Contact in case of EMERGENCY

First Name Last Name
Phone Number
Parental Consent for Medical Attention in Case of Emergency

I agree that my child (named above) has permission to attend Hong Kong Pony Club Camps and Events. All above information is correct and most up to date I agree that my child/children (named above) have permission to be given first-aid medical attention based on the situation. I give consent for my child to be taken to hospital in case of an injury that requires medical attention beyond first-aid. Should the HKPC not be able to reach the emergency contacts in a timely manner, I give consent for my child to be taken to the nearest hospital ER for immediate care.
Parental Consent for Medical Aid *

I agree to the above and certify that I have given all responses to the best of my knowledge in the interest of my child
Full Name of Legal Guardian *
Signature of Legal Guardian *

Clear
Should be Empty:

Hong Kong Pony Club Medical Consent Form