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Indemnity I the undersigned being the Parent/Legal Guardian of do hereby acknowledge that I/We shall have no claim whatsoever against Mondeor Meteors Football Club its coaching staff its committee members its maintenance/ground staff or any other associates of the Club which may arise as a result of any injuries damage or loss of personal items whilst participating in the training playing or watching sessions held at the Club grounds or away events while supporting or representing the Club. Mondeor Meteors Football Club 2010 Player Registration Form Player s Personal Information Player s Name Physical Address Postal Code Date of Birth School if applicable Seniors Ladies Vets Cell Identity Number Male Gender Female Player s Parent Information To be completed for all players under the age of 18 years Father s First Name Father s ID Number Father s Work Number Father s Cell Number Father s Email Address In the event of the parent s being divorced who is the Legal Guardian / Custodian Parent Are you able to offer sponsorship or assistance to the Club in any way Legal Guardian / Custodian Parent Detail Medical Information Allergies Medication Prescribed Other Medical Conditions Please note in terms of legislation a medical emergency the First Responder/First Aider may not administer any medication it is therefore imperative that we are aware of any medical conditions and that the Player s own medication is available in need. Should it be necessary for you your son or daughter to be taken to a doctor or hospital for additional attention this further information is required. Medical Aid Name Principle Member 2010 Registration Fee Structure Mini Mites R 680 Mighty Mites R 730 Junior Teams up to U17 R 800 Registration is from Saturday 30 January 2010. In order for registration to be completed 50 of the fees need to be paid. Fees are to be paid in full by 31 March 2010. In order for registration to be completed 50 of the fees need to be paid* Fees are to be paid in full by 31 March 2010. In the event of injury I/we hereby give permission for the necessary emergency action to be taken in the best interest of me my/our son or daughter. Suitable contact will be made to me/us. I/we hereby undertake to behave in an appropriate manner at all times when representing the club and adhere to and enforce the Clubs Code of Conduct at all times. Parent / Player s Signature Date For Office Use Fees Received In Full R Payment Option or Balance Due by Database Updated Kit Size Sponsorship Offered to Club Other Assistance Offered Committee Member s Signature Receipt Shirt Shorts Socks. In the event of injury I/we hereby give permission for the necessary emergency action to be taken in the best interest of me my/our son or daughter. Suitable contact will be made to me/us. I/we hereby undertake to behave in an appropriate manner at all times when representing the club and adhere to and enforce the Clubs Code of Conduct at all times. Suitable contact will be made to me/us. I/we hereby undertake to behave in an appropriate manner at all times when representing the club and adhere to and enforce the Clubs Code of Conduct at all times. Parent / Player s Signature Date For Office Use Fees Received In Full R Payment Option or Balance Due by Database Updated Kit Size Sponsorship Offered to Club Other Assistance Offered Committee Member s Signature Receipt Shirt Shorts Socks.