Emergency Contact Form "*" indicates required fields Step 1 of 2 50% Part 1: To be completed by Allotment Holder:Full Name* Plot Holder Emergency Phone Number*Allotment Site*Site:Foxby Hill AllotmentLove Lane AllotmentNorth Warren AllotmentShowfield AllotmentSpital Hill AllotmentAllotment Garden No* Address* Street Address Address Line 2 City ZIP / Postal Code What Animals are you Keeping? How many Animals are you Keeping?Consent* I agree that the emergency contacts can be contacted / left messages regarding my allotment garden animals if I am unable to be reached directly.Signature* This field will be classed as your digital signature upon submission of this form Date* MM slash DD slash YYYY It is a condition of your allotment tenancy agreement with the Town Council that you fill in this emergency contact sheet BEFORE you bring animals onto any of our allotment sites. ALL Tenants are responsible in law for looking after the welfare needs of their animals. These needs are described in the Council’s ‘Animals on Allotments’ Policy http://gainsborough-tc.gov.uk/wp-content/uploads/2020/12/Animals_on_Allotments_Policy.pdf. The Council must have a way of contacting you at all times in case of any urgent problem with the animals you keep on our allotment site. You must update us immediately of any changes to the emergency contact information. Part 2: Emergency contacts Please ask two people you know to be your ‘emergency contacts’ and get them to complete their emergency contact section of this form so we can contact you or them quickly. We will need to be able to leave a message on these numbers if we cannot speak to you. It is a good idea, but not a requirement to give these numbers (with your contacts permission) to the Tenants next to you so that they can let you or your emergency contact know straight away if they notice any problems with your animals. We are aware that phone numbers change but it is your responsibility to keep these contact numbers up to date. If we cannot contact you in an emergency because you have not told us about changes to your emergency contact numbers, we will ask you to remove your animals from our allotment site. If we cannot contact you and your animal needs urgent veterinary treatment, you will be responsible for repayment of the full cost of any treatment. Emergency Contact – to be completed by your emergency contacts Privacy Notice for Emergency Contacts When you complete this form, as a emergency contact for the tenant the information you provide (personal information such as name and phone number) will be processed and stored so that it is possible to contact you in the event of an emergency in relation to the Tenant named overleaf’s animals / plot if we are unable to contact the plot holder directly. Your personal information will not be shared with any third party without your prior consent. You can read the council’s Privacy Policy here:Privacy Policy – Gainsborough Town Council (gainsborough-tc.gov.uk) I agree that I have read and understand Gainsborough Town Council’s Privacy Notice. I agree by signing below that the Council may process my personal information for providing information and corresponding with me. I agree that Gainsborough Town Council can keep my contact information data for an undisclosed time or until I request its removal after the termination of the plot holder’s contract. I have the right to request modification on the information that you keep on record. Emergency Contact Name (1)* Emergency Contact Number (1)*Signature Contact (1)* This field will be classed as your digital signature upon submission of this form Date (1)* MM slash DD slash YYYY Emergency Contact Name (2) Emergency Contact Number (2)Signature Contact (2) This field will be classed as your digital signature upon submission of this form Date (2) MM slash DD slash YYYY Δ
