Young Demon Members Clinic

When: Wednesday 10^th July
Time: 1.00pm-3.00pm
Where: Gosch's Paddock
What: Junior members get the chance to participate in a clinic run by the players, there will be plenty of fun activities along with time for the kids to get a poster signed by some of the team at the end of the session.

Cost: Free for members, $25 for non-members (Please pay on the day)

Membership Number *

First Name *

Last Name *

Date of Birth *

Guest First Name ($25 per non member)

Guest Last Name

Guest Date of Birth

Guardian First Name *

Guardian Surname *

Guardian Phone *

Guardian Email Address *

Emergency Contact Name

Emergency Contact Phone

Does your child suffer from any illness or medical condition? Is she/he allergic to any drugs, antiseptic creams or anti-bacterial/infection lotions? (If yes, please detail) *

YesNo

Please Detail

Is there any food he/she should not eat for religious or health reasons? (Snacks may be provided such as fruit, juice and bread. If your child has very specific dietray requirements, please ensure they bring their own food) *

YesNo

Do you permit Melbourne Football Club to take your child to hospital when no contact can be made in an emergency? *

YesNo

Are you a member of the ambulance service? *

YesNo

I, the junior member's guardian, agree to accept full responsibility for the child(ren) nominated to participate in the Junior Football Clinic offered by the Melbourne Football Club on July 10, 2019. This form indemnifies the Melbourne Football Club from any liability that may be caused as a result of injury or loss as result of this football clinic. I authorise the Melbourne Football Club, in the event of any injury or illness to obtain such medical assistance as required and agree to meet any expenses incurred. *

YesNo

The Melbourne Football Club regularly takes photographs of fans for promotional purposes. These images may appear digitally or in print in any promotional or publicity materials (including the Club’s website) produced by the Football Club or organisations working in partnership with the Football Club. All photographs taken remain the property of the Melbourne Football Club, and individuals appearing in such images and/or their parents will not be remunerated for any use of such images. If you do not consent to images of yourself/your child being utilised by the Club for promotional purposes, please advise a member of staff at the relevant event, or email info@melbournefc.com.au. Crowd shots can be used at the discretion of the Club at any time, and are not subject to these conditions. I, the undersigned consent to images of my child being used for Club promotional purposes *

YesNo

All personal and sensitive information you provide will be used by the Club including for promotional and marketing purposes in accordance with our Privacy Policy, available at www.melbournefc.com.au/privacy and may be disclosed by the Club in accordance with the Club’s Privacy Policy. By providing your personal information, you agree to such use by the Melbourne Football Club.