Emergency Contact Information

This information will be extremely important in case of an accident or medical emergency.

Participant Details
Name*
First Name Last Name
Contact Number*
Email*
Primary Emergency Contact Details
Name*
First Name Last Name
Contact Number*
Relationship*
Additional Information
Comments
Include any special medical or personal information you would want an emergency care provider to know.
Consent*
I have voluntarily provided the above contact information and authorise Church of God Scotland and its representatives to contact the above person on my behalf in the event of an emergency.
Phone
This field is for validation purposes and should be left unchanged.

Participant Details