Parental Consent Form
Junior Player
Player Details:
First Name: ____________________________
Date of Birth: _____/_____/______
Last Name: ____________________________
Gender: Male
Female
I, the legal parent/guardian of the above named junior member, give my consent for my child to play
in basketball games with adult players, be it social, local competition, representative, or any other senior competition
that the Gympie Amateur Basketball Association (hereinafter referred to as the Club) agrees to allow my child to
participate in.
Consent is to last for the duration of the year the consent is given in, unless otherwise revoked by the Club.
I understand that playing with senior players may increase the risk of injury to my child, and acknowledge that the Club
will not be held liable or responsible for any event that may occur due to the nature of this consent.
Parent/Guardian Details:
First Name: ____________________________
Last Name: ____________________________
Signature: ____________________________________________________________________________
Date: __________________________________