Student Date of Birth *
First and last name *
Full address (i.e. 10 Happy Street, Labrador, 4215)
Parent/guardian full name *
Parent/guardian contact number *
Student Date of Birth *
Emergency contact name & relationship *
Emergency contact phone number *
Today's date *
Does the student have any of the following medical conditions?
Has the student had the tetanus booster?
Has the student had the tetanus booster?
Yes
No
Please detail any other medical or physical probems which would limit the student's full participation.
In the event of an accident or illness, I authorize staff to obtain or administer any medical assistance or treatment my child may reasonably require, including contacting my child's doctor.
I have provided the all relevant details relating to my child's medical or physical needs on enrolment and where relevant have updated this information.
I give permission for my child to ride in the MCCGC bus to and from Logan for the tournament.
I give permission to the Multicultural Communities Council Gold Coast Ltd (MCCGC) to use photos that have been taken of my child during Ready, Set, Goal activities. The photos will be used for the purpose of promotion and will continue to be used unless MCCGC is advised otherwise. I understand the photos can be used in any appropriate MCCGC publications, which include newsletters, flyers, brochures, the MCCGC website and MCCGC presentations. *
