Having read the statements above, I acknowledge that I have read this document and fully understand the risks associated with participating in this voluntary program. By acknowledging below, I certify that I have read the above, understand its content, and wish for my child to participate.
I have read and accept the terms of the below agreement.* By selecting Please selectI do accept


The American School of Doha (ASD) is collecting the personal information requested in this form in order to:
- Obtain lawful consent for your child to participate in the activity
- Help coordinate the activity
- Respond to any injury or medical condition that may arise during, or as a result of the activity.

The information will only be accessed by authorized school staff and will be dealt with in accordance with the confidentiality requirements of The American School of Doha.

The information will not be disclosed to any other person or agency unless it is for the purpose stated above.
T-SHIRT SIZE(Unisex): Please selectSMLXLXXL

STUDENT LAST NAME:
STUDENT FIRST NAME:
SCHOOL ID NUMBER *:
GENDER: Please selectFemaleMale

GRADE: Please select89101112

DATE OF BIRTH:
NATIONALITY:
QID EXPIRY DATE:
QID Number:
Please fill out all the below details
MOTHER'S FULL NAME:
MOTHER'S EMAIL:
MOTHER'S PHONE NUMBER(24/7):
FATHER'S FULL NAME:
FATHER'S EMAIL:
FATHER'S PHONE NUMBER(24/7):
EMERGENCY CONTACT (NOT PARENT/GUARDIAN): Please enter an emergency contact in Qatar that is not a parent/guardian.
EMERGENCY CONTACT FULL NAME:
CONTACT PHONE NUMBER(24/7):

Please fill out below information about medical conditions, allergies or other concerns.
ASTHMA? Please selectYESNO

USES INHALER? Please selectYESNO

DIABETES? Please selectYESNO

EPI-PEN? Please selectYESNO

Does your child require any medication? Yes
No
Please list all medications
Does your child have any allergies? Please selectYesNo

Please list all allergies your child has.
LIST ANY DIETARY NEEDS, MEDICAL CONDITIONS OR OTHER CONCERNS that we need to be aware of:
I/We accept and understand that volunteering involves certain inherent risks, dangers, and hazards that may cause serious personal injury. We understand that the inherent risks of this sport cannot be eliminated without jeopardizing the essential qualities of the sport. We have reviewed all of these risks and we understand and appreciate them and still desire to participate in this activity.

We certify that our child has no medical or physical conditions that could interfere with or compromise his/her safety in participating in this activity.

I authorize qualified emergency medical professionals to examine, and in the event of an injury or serious illness, to administer emergency medical care to the above-named student. I understand that there will be a qualified medical professional during the event, and in the case of an emergency, an ambulance will be called.

In the event it becomes necessary for event staff to obtain emergency medical care for the above-named student, we understand that neither the staff member nor the school assumes financial liability for the expenses incurred because of the accident, injury, illness and/or unforeseen circumstances.


Participation in this program does create potential for injury. Parents/guardians should be aware that the chance of injury is present while students are participating in this golf volunteer progra. If an injury should occur, all costs associated with their treatment is the parents'/guardians' responsibility. Those parents/guardians who do not wish to expose their child to this possibility should not sign this permission form.

In the event of injury to your child during their participation with this program, every effort will be made to reach you or your emergency contact in case of an injury or emergency. By signing this form, you give authority to any of the Qatar Masters Volunteer Program staff, or administrators to authorize emergency medical treatment for your child if you cannot be reached.

V. Indemnity/Hold Harmless
I, as parent/guardian, release, acquit, and forever discharge Qatar Masters Organising Committee, employees, board members, and agents from any and all liability resulting from any claims or causes of action for personal injuries, damage to property, medical expenses, and losses or damages of any kind whatsoever that may arise from my child's participation in this volunteer program.

By selecting "Yes" below you acknowledge you have read and filled out all information to the best of your knowledge.
DO YOU GIVE CONSENT TO ALL THE INFORMATION ABOVE? Please selectYesNo

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