Thank you for your interest in the ‘FAMILY PARTICIPATION Day Event.

Please complete the Combined  PARTICIPATION WAIVER and RSVP form below and we will look forward to welcoming you.

Please read the acknowledgement for your ‘PARTICIPANTS WAIVER’ details.
Thank you.

In consideration of Organisers accepting my application to participate in the program/activity,
I acknowledge, understand and agree that:

1. Organisers for the purposes of this declaration means Walking Football Tasmania Inc and includes, where the context so permits affiliated associations and their respective directors, officers, members, servants or agents.

2. Participating in this Walking Football Tasmania Inc program/activity carries with it the inherent risk of physical injury, including serious injury such as permanent disability, paralysis and even death.

3. I and the Child/Children under my supervision are medically and physically fit and able to participate in the Walking Football Tasmania Inc Activity and I will immediately notify Walking Football Tasmania Inc of any change to my fitness and ability to participate.
I understand and accept that Walking Football Tasmania Inc will continue to rely on this declaration as evidence of my fitness and ability to participate.

4. I will at all times comply with the instructions and safety procedures of Walking Football Tasmania Inc.

5. If required, Walking Football Tasmania Inc will arrange medical or hospital treatment (including ambulance transportation) for me. I authorise such actions being taken by Walking Football Tasmania Inc and agree to meet all costs associated with such action.

6. I acknowledge and agree Walking Football Tasmania Inc may in good judgement record part of a playing session for promotional purposes and release Walking Football Tasmania Inc and it’s photographers from any claims or remuneration associated with any form of damage, foreseen or unforeseen, associated with image use.
I also understand I have the right to revoke permission for use.

7. I have read and fully understand this Waiver and agree to release Walking Football Tasmania Inc from liability for any injury or other losses I incur, including acts of negligence to the fullest extent permitted by law.

To Note:
We ask a question about soccer playing history to have an understanding of skills or otherwise you and accompanying Child/Children may have to better provide for your participation.

PARENT/GUARDIAN and CHILD/CHILDRENS Details

ALL (TEXT) FIELDS, BUTTON SELECTIONS OPTIONS AND CHECKBOXES ARE REQUIRED


    PARENT/GUARDIAN Details

    Relationship to Child/Children e.g.Parent/Grandparent

    Enter your full street address


    Best Contact Number

    Please provide an Emergency CONTACT PERSON

    Please provide an Emergency CONTACT NUMBER

    Please select your age bracket
    20 - 2930 - 3940 - 4950 - 5960 - 6970 - 7980 +
    Have you played competitive Soccer before
    yes (a lot)yes (a little)not at all


    CHILD/CHILDRENS Details
    1. Child's Full Name (required)
    Please select Child's age bracket (required)
    9 - 1112 - 14
    How much competitive soccer has this Child played? (required)
    a lota little
    2. Child's Full Name
    Please select Child's age bracket
    9 - 1112 - 14
    How much competitive soccer has this Child played?
    a lota little

    Photography Consent
    I consent for myself and/or the above Child/Children to be photographed and/or videoed for possible use within the facilitator's promotional material.


    I have read and fully acknowledge the 'Participant Waiver with Walking Football Tasmania Inc'
    Please accept the 'Terms | Privacy' for this site (To view click here)

    Please prove you are human by selecting the plane.