Permission & Compliance

GBJJ Youth PAR-Q

Please complete the below for your child, in your child's name. This health and consent questionnaire must be completed before your child takes part in training or competition.

Child & parent / guardian details

Child's full name *
Child's date of birth *
Child's gender
Club / academy your child trains with
Parent / guardian full name *
Your relationship to the child *
Your contact number *
Your email address *
Home address

Emergency contacts

Emergency contact 1 — name, relationship to child and number *
Emergency contact 2 — name, relationship to child and number

A second contact we can reach if the first is unavailable.

Who is authorised to collect your child from sessions?

Please list the adults permitted to collect your child. We will not release your child to anyone else.

Health & medical

Can you confirm that your Dr or Health Care Professional has not advised your child to not participate in physical activity or exercise? *
GP name and practice

If you are happy to share them, so we can contact your GP in an emergency.

Does your child have Asthma? *

If Yes it is your responsibility to ensure your child has their pump in their kit bag / with you if you are present in each session.

Has your child ever been diagnosed with a heart condition or heart murmur? *
Has your child had any hospital treatment, surgery, a broken bone or a serious injury in the last 3 years?

Please give details, including roughly when it happened and whether your child has been given the all-clear to return to sport.

Is your child taking any medication?

Please list any medication your child takes, what it is for, and whether they carry it with them.

Does your child suffer with diabetes or epilepsy? *
Does your child suffer from any allergies?

Please give details, including what triggers the reaction, what treatment is needed and whether your child carries medication such as an inhaler or adrenaline auto-injector.

Has your child ever experienced chest pain, fainting, dizziness, or shortness of breath during exercise? *
Has your child suffered a head injury or concussion in the last 12 months? *

Martial arts carry a risk of head injury. This helps us follow UK concussion guidance and graduated return to play.

Does your child ever complain of joint pain, muscle pain, or injuries that effect movement? *
Has your child been diagnosed with any additional needs or health conditions not mentioned above?

If yes, please give description. This helps us make reasonable adjustments so your child can take part safely.

Are there any other reasons your child should not take part in physical activity?

For example a medical condition, a recent injury, or advice from a doctor or physio. If yes, please give details.

Permissions & consent

I agree that all jewellery will be removed, longer hair will be tied back securely and nails must be clipped and clean. *

Policies & declarations

Do you have parental responsibility for this child, or permission from someone who does, to give these consents? *
Have you read and agreed to the Great Britain Jujitsu safeguarding policy? *

You can read our safeguarding policy at any time. If you ever have a concern about a child's welfare, please speak to the club welfare officer or contact GBJ directly.

Do you and your child agree to follow the GBJ code of conduct, including treating coaches, officials and other members with respect and not using abusive language or behaviour? *
Do you agree to tell your club or GBJ straight away if anything on this form changes — for example new medication, an injury, a change of address or a change of emergency contact? *
Do you understand that Jujitsu is a contact sport and that, although we take every reasonable step to keep your child safe, there is an inherent risk of injury? *
Declaration *

I confirm that I have parental responsibility for this child, that the information I have given is correct to the best of my knowledge, and that my child is in good health and not knowingly incapable of engaging in the sessions. Please enter your name to agree.

Your answers are recorded with the date and time of submission.