ATHLETE INFORMATION:

Child's Full Name *

Child's Gender *

Child's Date of birth *

PARENT/GUARDIAN INFORMATION:

Parent/Guardian First Name *

Parent/Guardian Last Name *

Email *

Address *

Phone *

EMERGENCY CONTACT:

Emergency Contact Full Name *

Emergency Contact Phone Number *

MEDICAL INFORMATION:

Does your child have any medical conditions/injuries? Please provide details below (please include medications etc)

Any further information

I give “One Futbol” (ABN 97 675 539 483 ), and any of its representatives, employees and agents the irrevocable right to use my child’s name/photograph/ image/audio recording/video recording and likeness in all forms and manner for the purposes of advertising, media publicity, publication, general display or for any other promotional purposes. I waive any interest that I may have in the copyright to my childs image now or at any future time and acknowledge that I am not entitled, nor shall in the future be entitled, to receive any payment or consideration in respect of it and agree to make no claim against One Futbol for any payments for the Publication of my child’s image. *

Yes

I agree to privacy policy provided by OneFutbol. By providing my contact details, I agree to receive correspondence from the business.