What school do you attend?

Parent/Caregiver 1
Name:
Contact number:

Parent/Caregiver 2
Name:
Contact number:

Medicare Number

Private Health
Do you and your family have private health. If so please write your fund name and membership number.

Doctors Name and Phone Number

Dentists name and phone number

Medical Authorisation
It is the parent’s responsibility to ensure that the student is adequately covered for Medical, Hospital, Dental and Personal Accident & Injury Insurance. Maranoa Netball Association will not accept financial liability for such expenses if they should arise. Where supervision of the administering of medication is required while the student is away from home, parents will need to document details in separate correspondence to the Team Management.
Medical Authorisation
I hereby authorise the obtaining on my behalf of such medical assistance as my daughter may require in the event of accident or illness and guarantee to meet any cost incurred. I authorise the administering of anaesthetic if this is deemed necessary by the medical officer attending.

Photography Consent Form
I have read and understand the photography consent form.

Code of conduct for parents
I accept MNA's rules policies and procedures governing events and competitions in which my child participates and comply with the reasonable requests. I agree to abide by the Code of Ethics and accept that MNA may take disciplinary action if I breach the Code of Ethics.

Code of conduct for players
I accept MNA's rules policies and procedures governing events and competitions in which I participate and comply with the reasonable requests of MNA and accept I am a champion for netball. I understand sport is fun and personal growth and each person should be treated with respect. I agree to abide by the Code of Ethics and accept that MNA may take disciplinary action if I breach the Code of Ethics.