OCRDA SELF DECLARATION MEDICAL FORM
for COMPETITORS AGED 18-60 YEARS
PLEASE NOTE: Competitors under 18 or over 60 years of age at time of application MUST complete a different application form AND have a full Medical.
1. The purpose of this form is to obtain a factual report of your state of health and medical history and to indicate your fitness to participate in the Event. Should you need to complete a full Medical due to age or existing medical conditions, please request the Medical Declaration and Examination form from OCRDA or download from the forms section of the website www.ocrda.com
2. This form is designed to be completed by yourself and does not require to be signed by your Doctor. However, if you have doubts about any aspect of your fitness (including eyesight), you may wish to discuss these with your Doctor before you complete this form.
3. If you select "Yes" for any of the questions or you have added qualifying remarks, your form may require furhter assessment by a Medical Professional and you may be asked to submit to a formal medical examination.
Any assessment may initially be in the form of a telephone call enquiry WHO may only need to endorse this form on your behalf, along with a written confirmation of your statements to the Assessor. It is likely a fee will be charged for this service.
Additionally, the Medical Assessor may require a statement from your GP and/or to see you for an examination (again, a fee may be payable). Should you be passed as fit to race, you will need to obtain from them a completed Certificate of Fitness to Race with an expiry date, OR a statement that further medical assessment is NOT required.
You should submit a copy of the Certificate of Fitness to Race as well as this form as part of your Licence Application. Please ensure you retain the original of the Certificate of Fitness to Race, as you may need to provide further copies for future declarations.
4. It is your personal responsibility not to start in or to continue to participate in a powerboat race if you are or become temporarily or permanently unfit to do so for any reason.
5. Datat Protection: The information collected on this form will be used by the Organising Association for dealing with you as a participant in the Event and for administration of the Event. In the case of incident or an emergency, the Organising Association may disclose this information to the Emergency Services.
6. OCRDA reserve the right to refuse an application or suspend a licence if they feel the individual is unfit to race for whatever reason.