Liverpool Homeless Football Club
Drop in Session Player Disclaimer Form
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First Name
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Phone Number
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Next of Kin Details- Name and Number
*
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Name
Phone Number
Please list any medical conditions/ allergies/ injuries or any other information that may be relevant:
E.g Epilepsy/ Penicillin/ Struggle in crowds
I acknowledge that all participants will be responsible for making their own way to and from the designated pick up points.
I authorise the member of staff that has a valid emergency aid certificate on site to administer any emergency medical treatment, including signing a consent form on my behalf if required by the medical services.
I acknowledge that staff is only responsible for participants whilst they are attending the sessions. Staff cannot be held responsible for participants’ welfare once they have left the sessions.
I acknowledge and accept that the football club or respective staff shall not have any liability in respect of any loss or damage to persons or property whilst in attendance of the session, and that members of staff reserve the right to refuse participation in the activities.
Rules of Respect: I agree to make every effort to make these sessions fun and enjoyable by;
Avoiding racist, sexist or abusive language or behaviour
Not smoking or spitting during or around sessions
Not participating under the influence of drugs or alcohol
Respecting all members of staff, volunteers and each other
Respecting all equipment and facilities and promoting LHFC values of equality and diversity at all times
Please check one:
*
I Agree
I Disagree
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Signature
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Sign by using a touch tablet/screen or left click and hold as you sign with your mouse.
Date
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Month
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Day
Year
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What Session are you attending?
Powerleague
Knowsley
Tranmere
St Helen's
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