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Please fill out the health and accident form below and submit.

Health and Accident Form
This form is confidential and shall remain in effect until such a time as the person who signs this form indicates in writing any change of information.  In case of any changes, please notify a member of the BSC Board immediately.

The applicant agrees that the Blenheim Skating Club and/or its proprietors and coaches will not be held responsible for any loss, however caused, and agrees to the release of the proprietors and/or coaches from all claims or damages which may arise as a result of or by reason of such injuries or loss of any nature whatsoever.  If any injury takes place while on the ice, please notify someone in charge at the time, so if the injury is severe in nature an ambulance can be called and an accident report can be filed, and if necessary, a claim can be sent to our insurance company.

Medical issues to be aware of:

Thanks for submitting!

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