Junior Player Contract 2018 - Busselton Hockey Stadium...demands, losses and expenses incurred or...
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BUSSELTON HOCKEY STADIUM CLUB INC JUNIOR PLAYER CONTRACT 2018 Dear Parents and Players, For 2018 we are asking all players who nominate for Carnivals to fill in ONE player contract to cover all Carnivals held in 2018 Please tick all the boxes that may apply to you in 2018 € Smarter Than Smoking State Championships € South West Junior Hockey Carnival – Bunbury € Other _________________________________________ Nomination fees for each carnival will be advised and collected prior to each Carnival. For more information please contact the Stadium Office Regards, Kylie Kylie Callow Director of Juniors PH: 9754 2727 E: [email protected] E: [email protected] PO Box 179, Busselton, WA 6280 INFORMATION INCLUDED 1. PLAYER AND PARENT / GUARDIAN AGREEMENT 2. MEDICAL INFORMATION SHEET (2) 3. BHSC JUNIOR PARENTS AND PLAYERS CODE OF CONDUCT
Transcript of Junior Player Contract 2018 - Busselton Hockey Stadium...demands, losses and expenses incurred or...
BUSSELTONHOCKEYSTADIUMCLUBINC
JUNIORPLAYERCONTRACT2018
DearParentsandPlayers,For2018weareaskingallplayerswhonominateforCarnivalstofillinONEplayercontracttocoverallCarnivalsheldin2018Pleasetickalltheboxesthatmayapplytoyouin2018
€ SmarterThanSmokingStateChampionships€ SouthWestJuniorHockeyCarnival–Bunbury€ Other_________________________________________
NominationfeesforeachcarnivalwillbeadvisedandcollectedpriortoeachCarnival.FormoreinformationpleasecontacttheStadiumOfficeRegards,
Kylie KylieCallowDirectorofJuniorsPH:97542727E:[email protected]:[email protected],Busselton,WA6280INFORMATIONINCLUDED
1. PLAYERANDPARENT/GUARDIANAGREEMENT2. MEDICALINFORMATIONSHEET(2)3. BHSCJUNIORPARENTSANDPLAYERSCODEOFCONDUCT
PLAYERAGREEMENT
ThisAgreementismadebetween“thePlayer”andtheBusseltonHockeyStadiumClubInc(“BHSC”)ItisherebyagreedthatthePlayershall:
a) PlayinhockeygamesasarepresentativeteammemberoftheBHSC.b) Attendallpracticetrainingsessions,meetingsorotherevents,includingteamfundraising,as
requiredbytheBHSC.c) Conductthemselvesinaresponsiblemannerwithrespecttothecoach,manager,team
mates,umpiresandhockeyofficialsatalltimes.d) ComplywiththeBHSCCodeofConduct(availableatwww.busseltonhockey.org.au)e) Representtheirparents,theBHSCandthemselvesatalltimesinamannerbeyondreproach
andwithclearunderstandingsoftheirresponsibilitiesasateammember.f) Agreetopayalltravel,accommodation,teamnomination,uniformandothercostsleviedon
thePlayertoenableparticipationintheteam.Thisincludesanycostsassociatedwithdamagetoproperty,accommodationorvehiclesforwhichthePlayerwasresponsible.
g) Allowtheirimagetobeusedforphotographic,websiteorvideoreproductionforpromotionalpurposes.
h) Undertaketocomplywithallotherrules,guidelinesandconditionsapplicabletoyourrepresentativestatusnotcoveredspecificallyinthisagreementandunderstandthatnon-compliancewillresultintheapplicationofappropriatesanctionsasdeterminedbytheteammanagementand/ortheBHSC.
i) AcknowledgeandaccepttheinherentrisksofinjuryassociatedwithhockeyandagreetoassumesuchariskundertheCivilLiabilityAct2002.
j) AcknowledgethatBHSCisnotresponsibleforpaymentofanymedicalexpensesincurredbythePlayer.
PLAYERNAME DATE
SIGNED //
PARENT/GUARDIANAGREEMENT
I,asaparent/guardianofthePlayer,signthisContractandacknowledgeandagree:a) Tocomplywithalloftheobligations,policiesandguidelinesunderthisContract.b) Topayallmoniesbytherequireddates.c) Thatanyseriousbreachofbehaviourbyaplayermayresultsinthatplayer’simmediate
dismissalfromtheteamandacceptappropriatesanctionsbeingenforcedbytheBHSC.d) ThatBHSChasnoliabilityinrelationtoanyinjurysustainedbythePlayerwhileperforming
his/herobligationsunderthisContract,exceptinregardtoanyrightsthatmayhavearisenundertheTradePracticesAct1974.
e) AgreetoindemnifyBHSCandtokeepBHSCindemnifiedinrespectofallactions,claims,demands,lossesandexpensesincurredorsufferedbyBHSCarisingfromanyaction,injuryorillnesssufferedorincurredbythePlayer,exceptinregardtoanyrightsthatmayhavearisenundertheTradePracticesAct1974.
IMPORTANTNOTEONINSURANCE:BHSCwillensurethatallplayersarecoveredforaccidentalinjurysufferedwhilstundertaking:organizedtrainingfor,organizedteamtraveltoandfrom,andwhilstparticipatingin,hockeycompetitionasarepresentativeofBHSC,tothe‘basiclevelofcover‘providedbytheHockeyWAgroupinsuranceplan.FulldetailsofinsuredbenefitsareavailablefromtheHockeyWAwebsite,anddetailsofwhichcanbeprovidedonrequest.Itisimportanttonotethatassessmentoftheadequacyofthisinsurancecoverisaplayer/parent/guardianresponsibility,anditisnottheresponsibilityofBHSC.CovercanbetoppedupforindividualplayersasrequiredthroughtheHockeyWAwebsite.
FULLNAMEOFPARENT/GUARDIAN DATE
SIGNED //
CONFIDENTIALMEDICALINFORMATION
SURNAME:_____________________________________________GIVENNAMES:____________________________________________ADDRESS:__________________________________________________POSTCODE:____________HOMEPHONE:________________________________MOBILE:_____________________________DATEOFBIRTH:_______________________AGE:_________SEX:MALEFEMALESPECIALDIETARYREQUIREMENTS:(pleaseadviseyourteammanager)__________________________________________________________________________________________________________
EMERGENCYCONTACTDETAILS
SURNAME:________________________________GIVENNAMES:___________________________HOMEPHONE:________________________________MOBILE:_____________________________RELATIONSHIP:_____________________________________________________________________
CURRENTMEDICALHISTORY
CURRENTMEDICALPROBLEMS:__________________________________________________________________________________________________________________________________________REGULARMEDICATIONSSTATINGNAMEANDDOSAGE:______________________________________________________________________________________________________________________ALLERGIES:__________________________________________________________________________________________________________________________________________________________SPORTSINJURIES(Pleaselistanyinjurywhichiscurrent/recurringorrequiressurgery):_____________________________________________________________________________________________OTHERINFORMATIONWENEEDTOKNOWABOUT:__________________________________________________________________________________________________________________________
PASTMEDICALHISTORY
HAVEYOUHAD: ___Epilepsy Ifyes,pleasespecify:_________________________________________AllergiestoDrugs ___AllergiestoFood ___________________________________________________________AllergiestoInsects___Diabetes __________________________________________________________HeartProblems___Asthma/Bronchitis DATEOFLASTTETANUSIMMUNISATION:________________________Migraines/Headaches___Concussion DOYOUWEARAMEDICALERTBRACELET:YESNOINTHELAST3YEARSHAVEYOUSUSTAINED:AFRACTURE:YESNOIfyes,details:_____________________________________ADISLOCATION:YESNOIfyes,details:_______________________________HAVEYOUEVERBEENTREATEDFORHEAD,NECKORSPINALINJURY:YESNOIfyes,details:______________________________________________________________________OTHERPASTMEDICALPROBLEMS/INJURIESthatmayaffectyourperformance:__________________________________________________________________________________________________
HEALTHCAREDETAILS
MEDICARENUMBER:_________________________________PRIVATEHEALTH:YESNOFUND#:___________________DOCTORDETAILS:___________________________________________________________________DENTISTDETAILS:___________________________________________________________________
Tothebestofmyknowledge,allinformationcontainedonthissheetiscorrect
(ifunder18pleasehaveparentorguardiansign)
FULLNAME DATE
SIGNED //
Pleasereturnthisformtoyourteammanager.
