Registration and Medical Form.
Please print and complete the form below then bring along to your trials/first training date.
WHITTON JUNIOR NETBALL CLUB
REGISTRATION AND MEDICAL FORM
Name of Player ----------------------------------------------------
Date of Birth---------------- Age------------
Parent or Guardian--------------------------------------------------------
Telephone-------------------------------
E-mail---------------------------------------------------------
Emergency phone number---------------------------------------------------------
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School attended--------------------------------------
Name and address of family Doctor ------------------------------------------------
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Any known medical conditions (including current medication and known allergies ) or other factors
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§ I agree to my daughter taking part in the activities of the Whitton
Junior Netball club.
§ I consent to my daughter travelling by any form of public transport, minibus, or vehicle driven by a club coach or parent to any event in which the club is participating
§ I authorise the leader of the party, or any club official accompanying the party who may be present, to consent to such medical treatment (including inoculations, blood transfusions, or surgery which in the opinion of a qualified medical practitioner may be necessary during any period of time when my daughter is with the Whitton Junior Netball Club, and away from direct parental control and direction.
§
§ SIGNED---------------------------------( Parent/Guardian ) Date---------