FLAG FOOTBALL SCHOOL HOLIDAY CAMPS

PARENT/GUARDIAN NAME

First NameLast Name

PARENT/GUARDIAN ADDRESS

Street Address

Street Address Line 2

CityState

Post Code

PARENT/GUARDIAN EMAIL

PARENT/GUARDIAN MOBILE NUMBER

please use numbers only

ALTERNATION PARENT/GUARDIAN NAME

First NameLast Name

ALTERNATION PARENT/GUARDIAN MOBILE NUMBER

please use numbers only

CHILD NAME

First NameLast Name

AGE AT THE TIME OF CAMP

DATE OF BIRTH

Date

NAME OF SCHOOL PARTICIPANT ATTENDS

HOW DID YOU HEAR OUT ABOUT OUR CLINIC?

MEDICAL CONDITIONS

Does your child suffer from any medical condition/s? (asthma, epilepsy, diabetes, etc.). Please note any details of the medical managements program that the leader may need to be aware of

MEDICATION

Please provide details of any medications currently being taken, together with the dispensing routine.

ALLERGIES

Please provide details of any allergies to common foods, plants, insect bites, medications (e.g. penicillin) etc

ADDITIONAL COMMENTS AND INFORMATION

Is there any other information we may need to be aware of, that may impact on any of the activities undertaken during the activity?

MEDIA & PROMOTIONAL WAIVER

I consent to the following waiver I , the participant and/or parent or legal guardian, acknowledge that Bring It On Sports may produce promotional materials, including photographs and video recordings, at its events. I hereby grant Bring It On Sports, its successors, assignees, licensees, sponsors, television networks, and other commercial exhibitors the exclusive right to capture and use photographs and/or video footage of myself/my child. This includes the use of my/my child's name, face, likeness, voice, and appearance for promotional, advertising, and event-related purposes. I understand that these materials may be used in print, digital, social media, and other media formats without compensation, and I waive any rights to inspect or approve the final product. By signing this waiver, I release Bring It On Sports and all associated parties from any claims related to the use of these materials.

LIABILITY WAIVER

I, the participant / parent or legal guardian, understand that Bring it on Sportsactivities involve some risks of injury. Some of the inherent risks include,but are not limited to falls, collisions with participants or stationaryobjects, landing wrong on jumps, landing on other participants, over-exertion,attempting actions that are beyond a participant’s capacity, and unexpectedfailure of equipment. Other inherent risks include careless behaviour of theparticipant or supervisory or judgment error by Bring it on Sports staff (e.g.staff misjudging the capacity of the participant to perform a task). Furthermore I, the participant / parent or legal guardian, understand that minimal orserious injuries can occur in any physical activity. While it is impossible toeliminate all risk and possibility of injury, Bring it on Sports 1) hasdesigned the program with safety as a prime concern; 2) has trained staff onduty; 3) provides instruction and emphasises safe skill progressions. I, the participant / parent or legal guardian, hereby assert that my participation(or that of my minor child) is voluntary and that I (and my child) knowinglyassume all inherent risks. In consideration of permission to use the Bring it on Sports services, today andon all future dates, I, the participant / parent or legal guardian, on behalfof myself, my spouse, my heirs, my parents or guardians, personalrepresentatives, and assigns [hereafter referred to as Releasing Parties] dohereby release, waive, discharge, and covenant not to sue Bring it on Sports,its owners, directors, officers, sponsors, affiliates, employees, volunteers,independent contractors, equipment providers, agents, and facility owners [hereafterreferred to as Protected Parties] from liability from any and all claimsarising from the ordinary negligence of Bring it on Sports or the ProtectedParties. This agreement applies to 1) personal injury (including death) fromincidents or illnesses arising from participation in Bring it on Sportsactivities (including, but not limited to, instruction, individual or groupplay, parties, classes, school holiday programs, special events, use of Bringit on Sports equipment.) I authorise any representative of Bring it on Sports toconsent to and/or authorise any medical attention, treatment, surgery oradministration of drugs by qualified and licensed medical professional formyself or my child, should it be necessary.

PLEASE COMPLETE A REGISTRATION FORM FOR EACH PARTICIPANT.

ORDER & PAYMENT

Monday 28 September- Flag Football Camp at St Ives

(Ages 7 - 13 years)

$60.00 AUD Quantity

Tuesday 29 September - Flag Football Camp at Woolooware

(Ages 7 - 13 years)

$60.00 AUD Quantity

Wednesday 30 September - Flag Football at Daceyville

(Ages 7 - 13 years)

$60.00 AUD Quantity

Thursday 1 October - Flag Football at Eagle Vale

(Ages 7 - 13 years)

$60.00 AUD Quantity

Friday 2 October – Carlingford at Cox Park

(Ages 7 - 13 years)

$60.00 AUD Quantity

Wednesday 7 October – Enfield at Henley Park (Field 4)

(Ages 7 - 13 years)

$60.00 AUD Quantity

Wednesday 7 October – Goulburn at Carr Confoy Oval

(Ages 7 - 13 years)

$60.00 AUD Quantity

Thursday 8 October – Kellyville at Bernie Mullane Sports Complex

(Ages 7 - 13 years)

$60.00 AUD Quantity

Friday 9 October – Maitland at Maitland Park

(Ages 7 - 13 years)

$60.00 AUD Quantity

Total

Payment Methods

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FLAG FOOTBALL SCHOOL HOLIDAY CAMPS

ORDER & PAYMENT*

Payment Methods

ORDER & PAYMENT