Name of Participant / Club *

Date of Birth

Medical Conditions (or anything the coach should be aware of)

Emergency Contact Name *

Emergency Contact Number *

Email Address *

During the sessions, photographs and video clips may be taken for use on our social media pages, or promotional material. Please tick the box to confirm you give consent for this.

I give consent for photos/videos

As a parent/guardian/coach, I wish for my child/team to attend JONES JR Sports sessions and understand that JONES JR Sports are under no liability whatsoever in respect to any personal loss or injury which the above named participants (or players) may sustain during the sessions. I also hereby authorise the coaches to act for my child in their best judgement in any emergency situation requiring medical attention. *

I have read, understood and agree to the above statement

Parent/Guardian Name *

Consent Form

Thanks for completing the consent form. If you have any questions, please contact us at jonesjrsports@gmail.com

Thanks for completing the consent form. If you have any questions, please contact us at jonesjrsports@gmail.com

Newtownhamilton PS

Newtownhamilton PS

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