Kazoku Kan Judo Club

Kazoku Kan Open Adaptive Judo Championships 2020
Kazoku Kan Judo Club

Erdington Academy
Kingsbury Road
B24 8RE

20 September 2020

I agree that I am the competitor's parent/guardian and I hereby confirm that he/she has my authorisation to participate in the Kazoku Kan Open Judo event being held on Sunday 20th September 2020 I further confirm and warrant that to the best of my knowledge and belief that the competitor is able to participate in the Judo event. In permitting the competitor to participate, I am specifically granting my permission to the Kazoku Kan Judo Club to use the competitor's likeness, name, voice and words in television, radio, film, newspaper, magazines and other media and in any form for the purpose of advertising of communicating the purposes and activities of Kazoku Kan Judo Club and/or for applying for funds to support these purposes. If a medical emergency should arise during the competitor's participation in this event, at a time when I am not personally present so as to be consulted regarding the competitor's care, I hereby authorise the competition organiser on my behalf, to take whatever measures are necessary to ensure that the competitor is provided with any emergency medical treatment, including hospitalisation, which the competition organiser deems advisable in order to protect the competitor's health and well-being.

Additional terms for under 18’s By completing this entry form you also confirm that one of these statements applies:

I am parent/guardian for the above specified competitor and hereby give permission for them to participate at this event.
I am coach for the above specified competitor and can confirm that I have permission to enter them and for them to participate at this event.

Subtotal: £

Bank Administration Costs: £

Total: £

The online entry fee for this event is £12.