Next of Kin Form | Eloise Ansell

BioGeometry - Next of Kin Form

The venue has requested that we collect emergency contact (next of kin) details and any relevant medical information for everyone attending the BioGeometry course.

This is simply a precaution to help us keep everyone safe and ensure we have the information needed should an emergency arise.

Your information will be kept confidential, only accessed by the course organisers if necessary, and securely deleted after the course.

Please complete this short form before the course begins. Thank you!

Participant details:

Full Name:

Phone Number:

Country code

Phone number

Emergency contact details:

Full Name:

Relationship to participant:

Primary telephone number:

Country code

Phone number

Any further numbers or info for your emergency contact? (optional)

eg Second phone number, email

Medical Information:

Do you have any medical conditions, allergies or accessibility needs that the course organisers should be aware of for your safety during the event?

Yes

If yes, please provide any relevant details below: (optional)

Is there anything specific we should do to support you if you become unwell or experience a medical emergency?

Privacy statement:

This information is collected solely for use in an emergency during the BioGeometry course on 26–31 October 2026. It will only be accessed by the course organisers when necessary and will be securely deleted after the course.

Please tick to agree:

I confirm that the information provided is accurate and that my emergency contact is aware they may be contacted if necessary

I explicitly consent to the course organisers collecting and using the medical information I have voluntarily provided for safety and emergency purposes during the course, including sharing relevant details with emergency services if necessary.