Child's Name
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First Name
Last Name
Child's Date of Birth
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Child's Gender
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Please select your preferred location
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Monty Bennett Oval, Wentworthville
Joe McAleer Park, Glendenning
Mona Park, Auburn
Parent/Guardian Name
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Parent/Guardian Contact e-mail
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Parent/Guardian Contact Mobile Number
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Which school is your child currently enrolled at?
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What is your child's cultural heritage?
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If you have any medical conditions we should be aware of, please list them here and the necessary medical requirements.
*
How did you find out about the program?
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School flyer
Letterbox flyer
Social media
Word of mouth
Other
Program Terms and Conditions
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I, the participant’s parent/guardian named above, have agreed for our child/children to participate in the Usman Khawaja Foundation (UKF), Cricket Program (“UKFCRICKET”). I acknowledge and agree that the UKFCRICKET, is not limited to:
• a recreational sport activity, exercise and training programs; and
• may involve strenuous physical activity including, but not limited to, cardiovascular conditioning and training, and other various fitness/sport activities. I hereby affirm, and I affirm each time my child participates in the UKFCRICKET, that:
• I will provide UKF with any existing medical conditions that my child/children has and will ensure that I provide relevant medical/ emergency plans and my child’s medications are readily available (i.e. insulin, Ventolin, EpiPen, etc.)
• My child/children are in good physical condition and do not suffer from any injury which would prevent or limit their participation in this program; and
• My child/children are participating in the UKFCRICKET voluntarily and at their own risk. I hereby release the Usman Khawaja Foundation (UKF), and their officers, agents and employees (the “Released Parties”) from any claims, demands, and causes of action as a result of their participation in the UKFCRICKET, to the extent permitted by law. I fully understand that my child/children may injure themselves as a result of their participation in the UKFCRICKET and I hereby release the Released Parties from any liability now or in the future for conditions that they may obtain directly or indirectly from participating in the UKFCRICKET, to the fullest extent permitted by law. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to joints, muscles or tendons, or any other illness or soreness that my child/children may incur, including death.
• I understand that pictures and videos taken by UKF throughout the UKFCRICKET may be used by UKF on its social media, website and other promotional materials.
