Junior animal experience indemnity

Name and surname of group leader (must be over 18) *

Which experience will you be doing? *

Date of experience *

Age of participant(s) *

Address *

Mobile number

Email

Date of last tetanus vaccination (vaccination is not mandatory)

Does the participant have medical and/or behavioural conditions or disabilities we should we aware of? *

Details of medical or behavioural conditions

Does the participant require a carer to accompany them? *

Carer's name and contact number

Is the participant taking medication? *

Details of medication

Is the participant allergic to anything else? *

Details of other allergies

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