NZSSRA: Medical Alert

REGATTA NAME  
SCHOOL NAME  
Regulation 6.1.D States:
In the event of any rower having a medical condition that should be brought to the attention of the Regatta Committee for safety reasons, such shall be given on the MEDICAL ALERT FORM. Persons susceptible to asthma attack must be notified.
  1. The Regatta Committee shall prepare a schedule by event of such persons' names and schools and distribute this information to the Safety Officer, The Medical Officer, the Umpires and the safety boat.
  2. The information and Medical Alert forms shall be destroyed following the conclusion of the regatta.

This is to advise, the following representatives of this school have a medical condition associated with an increased on-water risk that for safety reasons should be notified to the Regatta Committee.
Tick the appropiate colum or write down the condition in the 'Other' column if it is not already listed.

PUPIL NAME EVENTS Asthma Diabetes Epilespy Severe
Allergy		 Other (please list)
             
             
             
             
             
             
             
             
             
             
             
             

Principal  
 		 Date  

© Copyright NZSSRA 2003-2024