New form test - Khosa Rugby

Player and parent information

First Name of Parent *

Last Name of Parent *

Cellphone of parent *

Email Address of Parent *

First Name of Player *

Last Name of Player *

ID Number of Player *Please enter full ID number (not just birth date)0 / 13

Cellphone of player *

Email Address of Player *

Street Address *

Suburb

Postal Code

Previous club (if any)

What position do you play?

School

Age group *

Does the player have any Medical conditions or prescription medicine? *YesNo

Please describe medical condition

Emergency contact details

Name and Surname of emergency contact person *

Phone number of emergency contact

Relation to player *

Photo

No file chosen

Please upload a photo of the player

ID

No file chosen

Please upload a copy of the players ID

Personal information & media consent (POPIA)

How we handle your and your child's information

Khosa Rugby Club (the responsible party) collects the personal information in this registration to register your child, contact you, manage participation and safety, and meet its safeguarding obligations. Your child's personal information is processed with your consent as the parent or legal guardian. We keep information secure, use it only for these purposes, keep it only as long as necessary, and do not share it except as set out below or where the law requires. You may withdraw any consent below at any time by writing to admin@khosarugby.co.za. Supplying this information is voluntary, but some items are needed to register your child and are marked as required.

Social media use of images *Practice and game-day photographs and video are taken and may be used to promote the club. We will not publish your child's full name with their image, or any contact details.Yes — I consent to images of my child being used on Khosa Rugby Club's official website and social media channels.No — I do not consent to images of my child being used on social media.

Press & GLRU use of images *Yes — I consent to images of my child being used by the media and by the GLRU for coverage and promotion of rugby.No — I do not consent to press or GLRU use of my child's images.

Live streaming *Home and away matches may be live-streamed, and the links shared with participating clubs and posted on the club's social media channels. Wide match footage may capture any player on the field; if you decline, the club will not deliberately feature your child but cannot guarantee they never appear in general match play.Yes — I consent to my child appearing in live-streamed match footage.No — I do not consent; please do not deliberately feature my child in streamed footage.

Sharing with programme partnersI consent to limited information being shared with partners who assist the club's programme, only for that purpose. (Optional — leaving this blank will not affect registration.)

Participation, assumption of risk & medical authorisation.

Medical treatment authorisation *If my child is injured or ill during a club activity and I cannot be reached in time, the club may need to act.Yes — I authorise the club's appointed coaches, managers or first-aiders to administer basic first aid and to arrange emergency medical treatment or transport for my child as reasonably necessary. I understand the club will contact me as soon as possible.No — I do not authorise this (I will provide alternative arrangements in the field below).

Alternative medical arrangements

Transport to and from matchesIt is preferred that you arrange your child's transport to and from matches. Where you cannot, the club may occasionally arrange transport. As a safeguarding measure, a coach will not transport a child alone other than in a genuine emergency, and any such arrangement is recorded and you are informed.I consent to my child being transported to and from matches by a parent or, where I cannot arrange transport, by a club coach or organiser under the club's safeguarding arrangements. (Optional.)

Members' code, safeguarding acknowledgement & declaration.

Khosa Rugby Club Code of Conduct for members

Khosa Rugby Club exists to serve the social and sporting needs of the community. This code sets a shared standard for the benefit of all members and guests. Our values are respect for yourself, respect for others, and responsibility for your actions. Players and parents are asked to support the coaches and committee, show good sportsmanship and civility to team-mates, opponents, officials and spectators, follow the club's safeguarding rules, and treat the club's facilities and property with care. The full Code of Conduct for Members, Parents and Players is available from the club.

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