CONSENT FORM

TO WHOM S0 EVER IT MAY BE CONCERN

I ____________________________________Father/Mother of ___________________________________
Class _______Sec______ G.R.No.___________ hereby give consent for my ward to join the Sports Academy
for the session 2023-24.
Game preferred __________________________________________________________________
Batch/Timing: Batch 1(4:00pm – 5:00pm) / Batch 2(5:10pm – 6:10pm) / Batch 3(Friday 7:00am-9:00am)
Departure: Walking ( ) Driver ( ) Parent ( ) Brother/Sister ( ) Cycle( )
Name of the driver: ____________________________________ Mobile No: _________________________
Local Address: ___________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Gender: ___________________________________________________________
Date of Birth (DD/MM/YYYY):__________________________________________
Blood group of the student: ___________________________________________
Father’s Contact Number: ____________________________________________
Mother’s Contact Number: ____________________________________________
Any previous medical history? (if yes please specify):
_______________________________________________________________________________________
_______________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
The above information provided is all true & correct to the best of my knowledge.
I have read and understood the rules, regulations, and guidelines of the sports academy & I agree to abide
by them.
I also understand that the event might involve some risks for which I will not hold any staff or the
school responsible.
I take the responsibility to drop off and pick up my ward on time punctually.

Signature of the Father/Mother _________________________________ Date: _____________________