Register – Rising Stars

RISING STARS REGISTRATION FORM

All Rising Stars athletes must complete an individual registration form. All details will be kept confidential. It is important for the wellbeing of the players that this form be completed fully and accurately.

1Personal Information

2Medical Information

3Legal Information

Student Full Name
Parents/Guardian Full Name*
Parent / Guardian First & Last Name*
First Last
Parents/Guardian Mobile Number*
Parents/Guardian Email Address*
Address
Street Address City State Post Code Country
School
Student School Year
Program selection
2 and 3 Day Camps
Total
$ 0.00

STATEMENT OF ACKNOWLEDGEMENT/RELEASE AND CONSENT I acknowledge that this program involves strenuous physical exercise and physical contact with other participants and that participation in this programme is undertaken entirely at my child’s own risk. In consideration of Rising Stars agreeing for my child to participate in the Rising Stars Football Academy programme, I : (a) acknowledge that Rising Stars will not be responsible or liable for injury; and (b) to the extent permissible by law, hereby release and discharge Rising Stars from all responsibility and liability, including liability for negligence for, any injury, loss or damage to personal effects which my child may suffer or incur as a result of my child participating in Rising Stars training sessions or other activities. In the event of an emergency or non-emergency situation requiring medical treatment, I hereby grant my consent for any and all medical attention to be administered to my child, in the event of an accidental injury or illness, until such time as I can be contacted. This consent includes, but is not limited to, the administration of first aid and the use of an ambulance I also understand that I am responsible for the costs of such attention. I further acknowledge that if my child has a pre-existing medical condition that requires medication in an emergency situation, such as Epipen or Ventolin, it is my sole responsibility that my child carries this medication with them at all times.
I Agree*
- Yes
Over the course of your child’s enrollment / participation with Rising Stars AFL Football Academy, your child will appear in photographs and video that feature on our web page, brochure and social media platforms. These will be for formal and activity- based, named and unnamed. I provide permission for images of my child as a participant of Rising Stars AFL Football Academy to be used in our web page, brochure and social media platforms.
I Agree*
- Yes
Fees are non refundable. In the event of a long term injury resulting in training needing to cease, refunds will be awarded at our discretion. Rising Stars will need clarification from a practicing medical practitioner in order to award a refund.
I Agree*
- Yes

RISING STARS REGISTRATION FORM

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