Junior EOI Form
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  • Southern Vikings Juniors

    Register your Interest NOW!! Can’t wait to see you!!
  • Format: (000) 000-0000.
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  • PARENT/GUARDIAN INFORMATION

  • Format: (000) 000-0000.
  • Participation Waiver and Medical Consent

    1. Informed Consent and Acknowledgement

    I, the undersigned participant or parent/legal guardian of the named participant, hereby consent to participation in all activities organised by the Southern Vikings American Football Club (“Southern Vikings”), including but not limited to training sessions, matches, club events, and league activities under Gridiron Victoria and American Football Australia.

    I acknowledge and accept that participation in contact sports such as American football involves inherent risks, including but not limited to bruises, fractures, concussion, spinal injury, paralysis, or death. I voluntarily assume all such risks associated with participation and travel to/from related activities.

    In consideration of the Southern Vikings accepting this participation, I hereby release, waive, and hold harmless Southern Vikings, Gridiron Victoria, American Football Australia, Barend Photography, On Side Kick Productions, their officers, coaches, staff, agents, volunteers, affiliates, sponsors, and any owners or lessors of used premises from any liability, claims, or causes of action for personal injury, property damage, or loss arising from participation, except where directly caused by proven negligence.

    2. Medical Release and Authorisation

    In the event of a medical emergency where I (or the participant, if a minor) require immediate attention, I authorise qualified and licensed medical professionals to provide treatment as deemed necessary to prevent life-threatening circumstances, physical impairment, disfigurement, or serious pain.

    This includes but is not limited to medical examinations, imaging (e.g. x-rays), minor surgical procedures, and immunisations. I understand that every reasonable effort will be made to contact me or another emergency contact before proceeding with major medical decisions. However, if contact cannot be made promptly, I consent to any necessary treatment in good faith.

    If the participant is a minor, I further authorise Southern Vikings, Gridiron Victoria, and their representatives (including coaches and team officials) to initiate emergency first aid or care before transfer to a medical facility.

    This authorisation remains valid for the duration of the participant’s registration with the Southern Vikings during the current Gridiron season.

    3. Zero Drug and Alcohol Policy

    All participants are strictly prohibited from:

    • Attending practices, games, or events while under the influence of alcohol, illicit drugs, or misused medication.
    • Possessing or using alcohol or drugs on sidelines, club venues, or during any official football-related activity.
    • Violation of this policy will result in immediate removal from club and league participation, as determined by Southern Vikings or Gridiron Victoria.

    Media Consent and Waiver

    1. Consent and Authorisation

    By signing this form, I (or as the parent/legal guardian of the minor named below) give permission to the Southern Vikings American Football Club (SVAF Club) and its authorised representatives—including but not limited to Gridiron Victoria, American Football Australia, Barend Photography, and On Side Kick Productions—to capture, record, and use my (or my child’s) image, voice, likeness, and/or statements in any form of media including video, photographs, audio recordings, or written content.

    2. Purpose of Use

    I understand that the materials may be used for purposes including but not limited to:

    • Promotional campaigns
    • Social media and website content
    • Educational and training resources
    • Live-streaming or recorded match coverage
    • League or club-related publications and archives

    These materials may appear in public and commercial channels, including websites, social media, print, or broadcast media, and may be shared with third-party partners in connection with football-related activities.

    3. Rights and Release

    I grant full, irrevocable, royalty-free permission for the above parties to use, edit, reproduce, distribute, and publicly display the materials without further notice, approval, or compensation.

    I acknowledge that:

    • I waive any rights to inspect or approve the finished product;
    • I waive any claims arising from use, including (but not limited to) defamation, invasion of privacy, breach of confidence, or infringement of moral rights under the Copyright Act 1968 (Cth);

    This consent is given in accordance with relevant Australian and Victorian laws as of 27 June 2025.

    4. Duration of Consent

    This consent is ongoing and applies in perpetuity unless formally revoked in writing. I understand that revocation will not affect materials already published or in production prior to notice being received and acknowledged.

    5. Data Handling and Privacy

    I understand that any personal information collected is managed in accordance with the Privacy Act 1988 (Cth) and the Privacy and Data Protection Act 2014 (Vic). The information will be used solely for the purposes described above and will not be disclosed to unrelated third parties without further consent unless required by law.

  • By completing and submitting this form, you signify your agreement to the informed consent and acknowledgment details provided.

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