Philippines U20 WNT Training Camp

AFC U20 Women’s Asian Cup Usbekistan 2024™ -

Quali ers Round 1
CONSENT AND WAIVER FORM

PHILIPPINES U20 WOMEN’S NATIONAL TEAM

CONSENT AND WAIVER FORM

I ___________________________________________, ______________________________ (nationality/ies) and with address

____________________________________________________________ hereby declare under oath:

1. I give Full Consent to participate in the Philippines U20 Women’s National Team Training Camp to be held on 24
February - 06 March 2023 at the PFF National Training Centre in Carmona, Cavite, and, if selected, in the Asian
Football Confederation (AFC) U20 Women’s Asian Cup Uzbekistan 2024 - Quali ers Round 1 to be held from
06-12 March 2023 in Vientiane, Laos.

2. To the best of my knowledge, I am in good physical condition and I am not aware of any physical in rmity that
would place myself at risk in participation in any way with the training camp and, if selected, in the tournament.

3. I am fully aware of the risks and hazards connected with the training camp and, if selected, in the tournament,
considering that football is a physical and contact sports, and during travel to-and-from the training camp and/
or tournament venues.

4. During the period of the training camp and, if selected, in the tournament, I hereby give permission of the
assigned medical personnel, assistant or rst-aid practitioner to administer appropriate rst-aid or emergency
medical attention to myself in the event of any accident, illness or injury and agree to be nancially responsible
for the cost of medical treatment beyond such rst-aid or emergency medical attention.

5. I understand that the PFF will take appropriate and reasonable safety precautions and measures to help ensure
my safety during the training camp and/or tournament.

6. I shall free PFF and/or all its directors, coaches, managers, of cers, representatives, employees and associated
personnel including those of its af liated organisations, and the owners and lessors of premises used to conduct
the event from any liability that could arise from any claims from injuries/sickness in relation to my participation
in the training camp and, if selected, in the tournament.

7. This Consent and Waiver shall bind members of my family and heirs.

8. I acknowledge and represent that I have read and understood this document and sign it voluntarily.

Signed this day of ______________________________ 2023 at ______________________________..

SIGNED BY:

___________________________________________________
Printed Name

___________________________________________________
Signature

___________________________________________________
Email Address and Contact No.

IN CASE OF EMERGENCY WHEN PARENT/GUARDIAN CANNOT BE REACHED, PLEASE CONTACT:

Name: ________________________________________________________
Home Number: ________________________________________________________
Mobile Number: ________________________________________________________
Medical/Hospital Insurance Company: ________________________________________________________
Phone: ________________________________________________________
Policy Holder’s Name: ________________________________________________________
Policy Number: ________________________________________________________
fi

fi

fi
fi

fi

fi

fi
fi

fi