MEDICAL FORM

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Personal
Do you suffer from any of the following? Tick if appropriate.
Do you take any medication regularly or for emergency use?
Do you wear contact lenses?
Have you suffered any major illness or injury in the last 12 months?
Is there anything at all not covered in this document that the coaching staff should be aware of? (i.e. past history)
Medical Consent of Treatment Acceptance
As the parent/guardian of the player whose details appear on this form, or player (if 18 years or older whose details appear above) hereby consent to the player’s participation in training activities and competition matches under the direction of the staff appointed by the South Springvale FC. In the event of a medical emergency, I authorise any treatments or procedures that may be deemed necessary by a legally qualified medical practitioner.