Online Registration

Killarney Santos Football Club

Indemnity and Consent form
To the coaches and organizers of Killarney Santos Football Club,
hereby permits him / her to partake in the sport and all scheduled events related to the sport.

I hereby appoint and authorise the Coach / Organizer in charge to act in my place as parent/guardian with full authority to consent to my child undergoing surgical and/or medical treatment. I undertake to pay the costs of such treatment. I fully understand and accept that all activities are undertaken at my child’s own risk. I am aware that neither Killarney Santos Football Club, nor its or any person associated with Killarney Santos Football Club accept responsibility for any loss, injury or damage that the person or property of my child may sustain whilst engaged in any Football, including inter-alia transport to and from the activity. I hereby waive any right that I or my child may have to claim compensation against Killarney Santos Football Club or its Coaches agents, employees, organizers, or other members, in respect of any loss, injury or damage incurred whilst engaged in any Club activity howsoever arising and whether as a result of negligence or otherwise and I indemnify Killarney Santos Football Club against all such claims. I agree and authorize that photo’s, statements, audio – visual recordings, video and sound bites taken, recorded, and collected from my Child during activities with Killarney Santos Football Club may be used free of charge and at the discretion of Killarney Santos Football Club as part of their marketing, communication, and fundraising campaigns.
In the case of an emergency, it is vital that the Killarney Santos Football Club and/or person in Charge has as much personal information as possible. It is to your own benefit to fill this in completely and accurately.

Details of child

Parent's Contact Details

Father's Details
Mother's Details
Alternative Contact

Cell: 082 826 0707

E- mail: info@santos-fc.co.za

Business Registration: 2023/607340/07

Killarney Santos Football Club

Indemnity and Consent form

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