Parent Consent Form

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St.

Francis Xaviers High School


Dias and Pereira Nagar, Naigaon West

PARENT CONSENT FORM for


STUDENT ACTIVITY/ATHLETIC/SPORTS PARTICIPATION

STUDENT NAME:

_____________________________ ________________________________
(Firstname Middle Name Last name

Standard/class : ______________

PARENT PERMISSION AND RELEASE:

I declare that my child/ward is fit and able to participate in cricket/football/ athletics/Sport


and has my permission to participate and/or compete in the above listed extracurricular sport
or activity.

I understand that school/ coaches are going to spend a lot of resources to train my child and I
consent for their participation in sports till they complete 10th standard.

I understand that my child may need to travel for sport tournaments and events. I
understand that I will provide transportation to and from home/school after practice
sessions and events unless otherwise arranged.

I realize that there may be an inherent risk of injury. The nature of the injury could be severe,
including the risk of fractures and other catastrophic injuries. I agree that in the event of
injury or illness, the staff member in charge of the team may act on my behalf and at my
expense in obtaining medical treatment for my child. School, trustees, coaches and staff are not
responsible for any expenses incurred.

I understand that my child is responsible for her/his behaviour at all times, and agree not to
hold the school, trustees, coaches and staff responsible for any expenses or damages
incurred as a result of my child’s behaviour. I also understand that any violation of the
school’s code of discipline may result in exclusion from the team.

_________________________________________________ _________________
Parent/Guardian signature Date

____________________________________________ ____________________________________
Mobile number 1 Mobile number 2

***Please return this form to the PT teacher /coach

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