Transcript MSN Perak “Merdeka” Junior Tennis Championships 2014

MSN PERAK MERDEKA CLOSED JUNIOR TENNIS
CHAMPIONSHIP 2014
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Parental/Guardian Consent & Acknowledgement Form
A.
I hereby give consent for my child ____________________________________ (Mykad no/ BC no./Passport No.
_______________________ (“Participant”) to participate in the activities conducted and/or sanctioned by Perak Lawn
Tennis Association (“PLTA”), where activities shall bear the meaning prescribed in paragraph B below (hereinafter referred to
as 'the Activities’).
B.
For the purpose of this Consent & Acknowledgement, activities shall mean any and/or all of the following activities
sanctioned, implemented, conducted, arranged and/or otherwise organised by the Organiser, undertaken by the Participant,
as a player and/or in such other capacity relating to the game of tennis, as may be conducted and/or organised the
Organiser. For the avoidance of doubt, the activities shall be carried out at MBI Tennis Court and/or at such other venue as
may be determined by the Organiser (“Venues”), and the Participant may be required to stay at the venues for such duration
as may be deemed necessary for the success of the activities.
C.
I fully understand and am aware of, and hereby acknowledge that my child/ward understands and has been made aware of,
the risks involved in his/her participation in the activities, including the risk of death or serious injury. In this regard I hereby
agree as follows:(a) to accept any and all responsibility for his/her safety and welfare while participating in the activities;
(b) to release and hold harmless the Organiser, and its respective committee and members, agents, associates, sponsors,
staff and independent contractors (hereinafter collectively referred to as ‘The Released Parties’) from all responsibility and
liability for any injury or claim arising from participation in the activities at the venues;
(c) that no legal action shall be taken against the Organiser because of any accident or mishap involving the participation of
my child/ward in the activities at the venues;
(d) that the Organiser and/or any of the other Released Parties is hereby expressly authorised to administer or request
emergency medical treatment for my child/ward should such treatment be deemed necessary in the event of any accident or
mishap at the venues involving my child/ward while engaged in the activities.
D.
I consent to the disclosure by the Organiser of all records relevant to his/her athletic eligibility including, but not limited to,
his/her records relating to ranking, age, discipline, finances, residence, health/medical information and physical fitness.
E.
I grant the Released Parties the right to photograph and/or videotape my child/ward and further to use said child’s/ward’s
name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, promotional and
commercial materials without reservation or limitation. Notwithstanding the foregoing, the Released Parties are however
under no obligation to exercise said rights herein.
F.
I understand that the authorizations and rights granted herein are voluntary and that I may revoke any or all of them at any
time by submitting said revocation in writing to the Organiser. By doing so, however, I understand that my/our child/ward will no
longer be eligible for participation in the activities.
I HAVE READ THIS CAREFULLY AND HEREBY CONFIRM THAT I AM AWARE THAT IT CONTAINS A
RELEASE.
_________________________________________________
Name of Parent/Guardian (printed)
_________________________________________
Signature of Parent/Guardian
______________
Date