MEDICAL CERTIFICATE
The first part of this form must be signed and stamped by the doctor or the doctor may transcribe the entire text below (*) on his letterhead.
The second part must be completed by the parents of minors.
If you already have a valid certificate, have your doctor add the following sentence and fill in the individual declaration below if the pupil is a minor.If you are already in possession of a valid certificate, have your doctor add the sentence below and complete the individual declaration below if the pupil is a minor..
Fill in in CAPITAL LETTERS
I, the undersigned, Dott. ……………………………………………….……………….…………………………………………………
Doctor's address …………………………………………………….………………………….………………………………
Certifies that Mr/Mrs. …………………………………………………….………….…………….……………………………
(*) The subject does not have any current pathologies or contraindications to non-competitive sports characterised by a particular cardiovascular commitment (pursuant to Ministerial Decree 24/04/2013 and 08/07/2014).
STAMP AND SIGNATURE OF DOCTOR
┌───────────────────────┐
└───────────────────────┘ data .................……………………..
(*) sailing courses are based on intense sporting activity and therefore require considerable stamina and a perfect nervous balance
COMPULSORY PART:
The student must list below any major illnesses or problems which do not affect sailing but which he/she feels should be highlighted, such as allergies, food incompatibilities or other issues, so that they can be taken into account for both nutrition and needs:
…………………………………………………………….………………………………….……………………………..…………
..……………………………………….………………………………………….…………………………………..……………..…
We recommend It is also advisable to have a tetanus vaccination and to bring a copy of your tetanus card with you..
INDIVIDUAL DECLARATION FOR MINORS (MANDATORY)
The parent exercising parental authority over the child Surname and Name ............................................................:
Student's surname and first name ………………………………………….……………..………………………………………
Course .................. Shift
Declares below that the student has listed any major illnesses or problems that do not affect sailing, but which he/she feels should be highlighted, such as allergies, food incompatibilities, etc., so that they can be taken into account for both nutrition and needs.
………………………………………….………………………………………………………………..………………….…………
……………………………………….………………………………………….…………………………….…………….…………
Person to be notified in case of emergency ………………………………………………………………….……..………
Telephones (with prefixes) ………………………………………….……………………………..………………………………
IMPORTANT NOTE
I, the undersigned, exercising parental authority over the child (indicated above), AUTHORISE those responsible for Centro Velico Caprera to take any action on the said child that is deemed essential by a doctor or hospital in the event of need or hospitalisation.
Date................................... Signature of the person exercising parental authority......................................................