Parent's Full Name (Emergency Contact)*
Parent's Email (Emergency Contact)*
Parent's Phone Number (Emergency Contact)*
Child's Full Name* Child's Date of Birth*
If your child has any medical conditions we should be aware of please list them here and the necessary medical requirements* Release - I release, indemnify and hold harmless Social Development Inc, including His Highness Prince Aga Khan Shia Imami Ismaili Council for Australia and New Zealand, its portfolios, members, staff, volunteers and agents (including the AKYSB and Tournament Team Members) from all liability, claim or expense, however arising, in anyway connected to the Participant’s involvement with the Tournament. I consent to use of photos on social media and receive communication via SMS related to the event. Release - I release, indemnify and hold harmless Sydney Suburban Sports Club Incorporated (ABN - 30 133 885 022), including its, members, staff and agents from all liability, claim or expense, however arising, in anyway connected to the Participant’s involvement with the Tournament. I consent to use of photos on social media and receive communication via SMS related to the event. Medical - In the event of a medical emergency, I hereby authorise emergency treatment to be administered by a volunteer on duty. I also give permission to be transported by ambulance to an emergency centre or hospital if needed. I further accept responsibility for all expenses incurred for the medical treatment in case of an emergency. Release - I release, indemnify and hold harmless Social Development Inc, including His Highness Prince Aga Khan Shia Imami Ismaili Council for Australia and New Zealand, its portfolios, members, staff, volunteers and agents (including the AKYSB and Tournament Team Members) from all liability, claim or expense, however arising, in anyway connected to the Participant’s involvement with the Tournament.
Media – I agree that I can be photographed, digitally recorded and otherwise captured both by the AKYSB volunteers and spectators. Permission is hereby granted to the use of photographs, videos and/or voice recording made during the event and publish on social media platforms, future event marketing or other presentational/educational purposes.