Player Details
Please provide details of the player who is participating in this activity.
First Name
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Last Name
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Date of Birth
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-
Month
-
Day
Year
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Gender
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Male
Female
Do you identify as being of Aboriginal or Torres Strait Islander origin?
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Yes
No
Please indicate if you have a disability:
*
Yes
No
Parent Detail
Please provide the following details for us to contact you back.
Full Name
*
Parent's/Caretaker's Full Name
Email Address
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Parent's/Caretaker's Email Address
Contact Number
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Parent's/Caretaker's Contact Number
How did you hear about us?
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Website
Clubs
Facebook
Newspaper
Email
Text Message
Word of Mouth
Photo Consent
Talent Publication Release Form: Football Northern Territory (FNT) Consent form for the use of photographs or video (Parents and children).FNT recognises the need to ensure the welfare and safety of all young people taking part in any activity associated with our organisation. In accordance with our child protection policy we will not permit photographs, video or other images of young individuals to be taken without the consent of the parents/carers and/or children.Your child will be taking part in the 2020 Superhero MiniMinis Come and Try to take place at Darwin Football Stadium. The program is being delivered by Football Northern Territory. FNT may wish to use photographs/videos in FNT publications such as, yet not limited to; newsletters, promotional brochures, flyers, advertisements, publicity material, social media (Facebook), grant applications and evaluation reports. Use of photographs/videos would typically be in connection with an achievement or participation in an event, including our programs. FNT will take all steps to ensure these images are used solely for the purposes they are intended. If you become aware that these images are being used inappropriately you should inform FNT immediately.
Please select from the below for your consent to the FNT Nominated Person photographing or videoing my child’s involvement in 2020 Superhero MiniMinis Come and Try.
*
Yes
No
Thank You
FNT staff will contact you shortly with further details. Thank you for your support.
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