Little Stingers Registration

PLAYER REGISTRATION & CONSENT FORM

PLEASE READ CAREFULLY BEFORE ADDING ANY INFORMATION

The information collected on these forms is for the purpose of keeping a database of the registered players at the Club.
This information is held recorded and stored in secure place. This information will be held until the player leaves the club, then it will be deleted. You have the right to request all information held on yourself and your child. You have the right to add, withdraw or alter any personal information contained herein.
None of the information contained in these documents will be shared with anyone else, unless you give permission to do so.

PLAYERS INFORMATION

Players Name

Date of Birth

Age Group

Home Address

Post Code

PARENT/GUARDIAN INFORMATION

Relationship to Player

Contact Number

Contact Email

DOCTORS INFORMATION

Doctors Name

Doctors Address

Doctors Contact Number

PUBLICITY CONSENT
I consent to the taking of photographs and or videoing during my childs involvement during the clubs activities.

Publicity Consent Yes/No

I consent to the club submitting match reports and other relevant articles to the media.

Publicity Media Yes/No

MEDICAL CONSENT
In the event of the club not being able to make contact with any of the named person and in situations whereby the administrators of first aid and/or other medical treatment by a qualified medical practitioner maybe required, I give my consent for the club to act in logo parentis on my behalf.

Medical Consent Yes/No

Does your child have any medical conditions that the club/coach be made aware of? e.g Allergies, Epilepsy, Asthma, Autism etc?

Medical Conditions Yes/No

Medical Condition Details

Does your child have any medical requirements that the club/coach or medical practitioner should be made aware of?

Medical Requirements Yes/No

Medical Requirement Details

PARENTS CONSENT
I agree to my child taking part in the clubs activities and to abide by it's rules and codes of conduct. I confirm that to the best of my knowledge all the information I have provided is accurate. I shall inform the club/coach immediately if there are any changes to any of the information provided on these forms.

Parent Consent Yes/No

NAME OF PARENT/GUARDIAN COMPLETING THESE FORMS

Parents Name

Relationship to Player