City of Greater Geelong

Online Forms

Basketball free-throw competition


Please complete fields marked withMandatory Field

 Young persons details
 

Mandatory Field Name: 

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Mandatory Field Asthama: 

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 Emergency Contact
 

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 Parent/Guardian Details
 

Mandatory Field Name: 

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Parent/Guardian declaration

I hereby consent to the above child/young person participating in BBall free throw and 3 on 3 holiday activity

in LMC on Monday 22nd September.

I hereby aslo agree to release, discharge and to hold the city of Greater Geelong harmless for any accidents,

harm or loss which my above child may suffer or that I may suffer as a result of the said child participating

in this activity.

I hereby give permission for the City of Greater Geelong to supervise my child/ren on this program and to seek

a ppropriate professional medical intervention if deemed necessary.


Mandatory Field