Adult Training Session - Weekly Subscription Submission

Athlete Name*

First NameLast Name

Athlete Email*

Confirmation Emailsharksvolleyball@example.com

Athlete Mobile*

Please enter a valid phone number.

Athlete Date of Birth*

Date

Athlete Gender*

Is the athlete prescribed an inhaler? If yes, please provide instructions for use.*

Does the athlete have any other allergies, chronic illness, or medical conditions? If yes, please describe.*

Please upload a proof of age (Birth Certificate/Drivers Licence/Passport)*

Contact Persons Name*

First NameLast Name

Contact Persons Mobile Number*

Please enter a valid phone number.

Contact Person Relationship*

Have you attended or experienced a 'Sharks' event before? (e.g Previous Weekly Junior Session/ A Sharks Camp)*

How did you hear about us?*

My Products

Adult SessionAttending regularly? Register for the Adult Session Weekly Subscription and only complete the form ONCE!

$11.00AUD for each week

Total

$0.00AUD

Credit Card

Medical Release and Authorisation
As Parent and/or Guardian of the named athlete, I hereby authorise the diagnosis and treatment by a qualified and licensed medical professional, of the named athlete, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunisations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorisation is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the SVA Corporation Pty Ltd ABN 60 661 547 744 (Sharks Volleyball) and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the named athletes admission to the medical facility.

Release authorised on the dates and/or duration of the registered season.

In the event that the named athlete is over the age of 18, the above waivers apply and the athlete gives consent and authorises all of the above. They also acknowledge that their execution constitutes the formal release of all liability from Sharks Volleyball in this matter and that they are sufficient to sign on their own behalf if required, as may be the case in this instance.

This release is authorised and executed of my own free will, with the sole purpose of authorising medical treatment under emergency circumstances, for the protection of life and limb of the named athlete, in my absence or inability to provide direction.

I understand that this payment acts as an upfront down payment for all sessions over the specified duration and therefore cannot be refunded without adequate cause.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature*

Policies and Procedures*

I have read and agreed to the Sharks Volleyball’s “Policies and Procedures”

To view our our “Policies and Procedures” please visit our website
www.sharksvolleyball.com/policies

Adult Training

Athlete Details

Emergency Contact Details

Credit Card