Junior Player Contract 2018 - Busselton Hockey Stadium...demands, losses and expenses incurred or...
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.