Patroller Declaration Form

Froglife provides free insurance to cover patrollers for Public Liability and Personal Accident

📋 Important Information

Froglife provides free insurance to cover patrollers for Public Liability and Personal Accident. To be covered, all patrollers must sign one of these forms and return it to us before patrolling.

You only need to fill this in once unless any circumstances change. You can put members of the same family on one form. Please see the Patrollers Health and Safety Information before filling this in. Further information can be downloaded from the website or posted on request (email toads@froglife.org to request this service).

Please write in BLOCK CAPITALS so that your information is clear and concise.

📄 Patroller Declaration Form

✨ Automatic Processing: Fill out the form below and click Submit. A PDF with your information will be automatically generated and emailed to the admin. You don't need to do anything else!

🔄 Alternative Option: If you prefer to fill out a physical form, download the blank PDF, complete it manually, and email it to admin@waltontoadpatrol.co.uk

📥 Download Blank Insurance Form (PDF)

YOUR DETAILS

Name(s) *

Address *

Email address (1) *

Email address (2)

CROSSING DETAILS

Toad Crossing (1) *

Site ID *

Toad Crossing (2)

Site ID

CONFIRMATION

I confirm that, I will be patrolling at these sites. I understand the risks associated with Toad Patrolling and agree to follow the Patroller's Health and Safety Information, and any further instructions from the local Patrol Manager. *

I will take responsibility for the following children and under 18s:

Name

D.O.B

Name

D.O.B

Name

D.O.B

All named persons must sign in the box below, or note 'returned by email'

Signature Confirmation * By typing your name, you electronically sign this declaration

Date *

I would like to be kept up to date with news and information from Froglife

Yes No

Your filled PDF will be sent to admin@waltontoadpatrol.co.uk

Need help? Email us at admin@waltontoadpatrol.co.uk