Girls Basketball Team Registration Form

HEALTH INFORMATION

This information will be kept confidential and will only be used for the purpose of supporting the participant’s needs
Medical Issues (e.g. Diabetes, Asthma, Heart issues, Anxiety, Panic attacks etc.)
Chronic illness (please specify):
Allergies in medication, food, other (please specify):
Dietary needs (e.g. vegetarian, vegan, gluten free etc.)
Current medication & supplements
Other (please specify):

PARENT / GUARDIAN CONSENT
Please add two individuals contact information
I, the Parent/Guardian, grant permission to United Sports Cyprus to use photographs and/or videos of the participant taken during activities for publications, news releases, online, and other communications related to the mission of USC. Any photos taken and shared will only show the participant from the back.
In the event of a medical emergency, I, the Parent/Guardian, give permission to the United Sports team to take my child to emergency care or provide first aid and medication.
SIGNATURE PARENT/GUARDIAN
Should be Empty:

INFORMATION AND REGISTRATION FORM