Roundhay Tennis Club Junior Player Consents

Roundhay Lawn Tennis Club

Details on this form will be held securely and will only be shared with coaches or others who need this information in order to meet the specific needs of your child.

If these details change please inform rltcwelfare@gmail.com
Name of child*
Child's date of birth*

MonthDayYear
Date
Child's gender*
Please detail any important access, faith, medical or additional needs that our organisation needs to know. Such as allergies, medical conditions e.g. asthma, epilepsy, orthopaedic problems, any current medication, special dietary requirements and/or any injuries.
PRIMARY EMERGENCY CONTACT FOR CHILD
Name*
Relationship to the child*
Address*
Mobile*
Phone Number*
Email*
example@example.com
SECONDARY EMERGENCY CONTACT FOR CHILD
Name*
Relationship to the child*
Address*
Mobile*
Phone Number*
Email*
example@example.com
It may be essential at some time for the responsible adult accompanying your child to have the necessary authority to obtain any urgent treatment which may be required whilst at this competition or event. Would you therefore please complete the details on this form and sign below to give your consent.
I, the parent/carer of the above named child hereby give permission for the responsible adult to give the immediately necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son/daughter's interest, in the doctor's medical opinion, for any delay to be incurred by seeking my personal consent

I agree to the above statement
Video & Photography Permission
In accordance with our photography and filming policy we will not permit photographs, video or other images of children (anyone under 18) to be taken without the consent of the child and their parent or carer.

The club will take all steps to ensure these images or video are used solely for the purposes they are intended which are as follows:

within the club for display purposes

within other printed publications

on the club social media pages

only using the first names of children, unless specifically requested below.
If you become aware that these images are being used inappropriately you should inform the club immediately.
The club may use photos/videos of your child for the duration they attend the club for coaching/training.
I give permission for

my child's photograph to be used on the club websitemy child to be videoed for use on the club websitemy child's photograph to be used on the club's social mediamy child to be videoed for use on the club's social mediamy child's full name to be provided on the basis it is necessary in the context of their role as a high-achieving player.my child's photograph to be used by the club for display purposes
I understand (tick to confirm consent)
and will comply with the club photography and filming policythe potential risks associated with the use and distribution of these imageshow the images or videos will be stored within the organisation and how long forthat if I withdraw consent for my child's image to be used or shared in the future, it may not be possible to remove images that have already been published or distributed.that at may events, the club and others will reasonably wish to take wide angle, general photos during or at specific points in the eventthat I must gain permission before sharing photographs/videos of other people's children on social
Parent/Guardian Name
Date

MonthDayYear
Date
Signature

Clear
Child's Name
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

PRIMARY EMERGENCY CONTACT FOR CHILD

SECONDARY EMERGENCY CONTACT FOR CHILD

Video & Photography Permission

The club may use photos/videos of your child for the duration they attend the club for coaching/training.