Parental Consent Form
Junior Player
Player Details:
First Name: ____________________________ Last Name:
____________________________
Date of Birth: _____/_____/______ 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: __________________________________