BMX Camp - Canberra 2021

Athletes Full Name:
Parent / Guardian Contact Name:
Parent / Guardian Contact Number:
Alt. Emergency Contact Name:
Alt. Emergency Contact Number:
Athlete Medicare Card Reference Number:
Place Number on Medicare Card:: eg. 1 or 2 or 3 etc.
Dietary Requirments:: If the Athlete has any special dietary requirements, please list. If NIL write NIL
Allergies:: If the Athlete has any known allergies, please list. If NIL write NIL
AGREEMENT: I (parent/guardian) give permission for my child (athlete) to attend the 2021 Canberra BMX Racing Camp as part of the South West Sydney Academy of Sport 2021 BMX Program.
Dates: Saturday 27th and Sunday 28th February
I (parent/guardian) understand that my child (athlete) will travel with the squad to, from and during the event.
I (parent/guardian) understand that ANY medication that is brought on tour needs to be in a ZIP-Lock bag, clearly labelled with the Athletes name and dosage required. I understand that this must be discussed with the program manager before getting on the bus departing from Camden.
Agreement:: I Understand and Agree
Parent / Guardian Name:: By writing your name you are signing to say that you have read and understood the consent form.