CONSENT TO TRAVEL FORM
For NELSON SUBURBS FC - Players Under 18 years of age
Player Information
- Full Name: __________________________________________________
- Date of Birth: _________________________________________________
- Address: _____________________________________________________
- City: _________________________________________________________
- Parent/Guardian Name: ______________________________________
- Phone Number: ______________________________________________
- Email: ________________________________________________________
Travel Details
- Club Name: ___________________________________________________
- Destination: ___________________________________________________
- Date of Departure: _____________________________________________
- Date of Return: _________________________________________________
- Coach/Team Manager Name: ____________________________________
- Emergency Contact Name: ______________________________________
- Emergency Contact Phone Number: ______________________________
Medical Information
- Allergies or Medical Conditions: __________________________________
- Medications Taken Regularly: _____________________________________
- Families Doctor’s Name & Contact: _______________________________
Consent & Agreement
I, (Parent/Guardian Name), give permission for my child, (Player’s Name), to travel with (Football Club Name) for the above-listed event(s). I understand that my child will be under the supervision of the club’s staff and that all reasonable safety precautions will be taken.
I authorize the club’s coaches, team officials, or designated representatives to act on my behalf in any medical emergency, including seeking medical treatment if necessary.
I release (Football Club Name), its staff, and representatives from any liability in case of injury, loss, or damage during travel, except in cases of gross negligence or wilful misconduct.
I confirm that my child is physically fit to participate in football activities and has no medical conditions that would prevent them from doing so safely.
Parent/Guardian Signature: __________________________________________________
Date: ________________________
Player’s Signature (if required): _______________________________________________
Date: ________________________