‘Super Me’ Sports Young Achievers Day with Vision Norfolk

Applicant details

Please fill out the details for each member of your family attending the activity.

Confirmation of Vision Impairment

To qualify for this activity the lead applicant (your VI child) must be either registered or registerable as blind or partially sighted (sight impaired/severely sight impaired). VICTA will ask for supporting evidence post application if we have not previously received it.

To be signed by the applicant or a responsible person.
a. I agree to take part in VICTA's activity and have read all the information sent to me.
b. I acknowledge the need to behave responsibly at all times during the activity.
c. I confirm that this form has been completed accurately and I undertake to update VICTA's organisers should any information contained on the form or personal circumstances change.
d. In the event of an emergency/accident, I consent to emergency medical treatment, which may include the use of anaesthetics.
e. We understand that some young people will use Whatsapp at home and each home has their own rules on technology. It is likely that your child will meet others on a VICTA activity that they’d like to stay in touch with. While we do not encourage the use of Whatsapp before the age of 16, we do encourage connections and friendships. We ask that if your child is coming on a VICTA activity and they use Whatsapp regularly to remind them their behaviour and language follows the expectations that we have when meeting in person – polite, courteous, and inclusive at all times. If you have any questions surrounding this, please contact the Activities Team on activities@victa.org.uk
f. By signing this form I consent to VICTA using the information supplied for the purpose of administering the named event. All the information will be treated in the strictest of confidence and made available only to those staff working with the participant. We may need to share your details with third-party suppliers in relation to this activity. Contact information will be retained and used for marketing of other relevant services.
g. I give consent for VICTA to carry out the following in accordance with the UK General Data Protection Regulations as supplemented by the Data Protection Act 2018 and related laws and to store my personal information on VICTA's database and/or any other suitable system.