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BASEBALL
IRELAND - Parental Consent Form
I,
the parent of ________________________________________________________,
hereby give permission for my child
to partake in the adult leagues, activities
and competitions organized by Baseball
Ireland for the 2004 season. I understand
that baseball is a risk sport, where
injuries can and do occur.
In
the event of my son/daughter being taken
ill or being injured while playing baseball,
so that a surgical operation or serum
injection becomes necessary, I hereby
authorise
_____________________________________________
(Manager) or a representative designated
by him/her to sign on my behalf any
written form of consent required provided
that the delay necessitated to obtain
my signature might endanger my son/daughter's
health or safety.
I
confirm the following details regarding
my child:
Date
of Birth:___________________
Medical
conditions A&E departments should be
aware of:
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Name
of family GP:____________________________________________________
Phone
number of GP:__________________________________________________
I
confirm the following contact details:
Parents
Home Phone:__________________________________________________
Mobile
Phone:_______________________________________________________
Work
Phone:________________________________________________________
Address:___________________________________________________________
_______________________________________________
_______________________________________________
Signature
of Parent:____________________________________________________
Date:________________________________
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