2019 Football Camp
Venue: University of Ghana Main Field, Legon
Date: 29th June 2019
Time: 7am

Full Name

Date of Birth
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School/ Institution

Sport Discipline

Email Address

Residential Address

Phone Number

Guardian Phone Number

Parental/ Guardian Consent

I give consent for my child to participate in the above activity, and I execute the above liability release on their behalf

Consent for Medical Treatment

I do hereby approve my child’s participation in the Ezekiel Ansah Football Camp on June 29th at the University of Ghana Main Field. I certify that my child is in good health and able to participate without limitation. In the event that a medical emergency occurs, and I am not on the premises or cannot be contacted, I give my permission to secure medical attention.

All participant must bring their recognized I.D card to prove their age

Parent/Guardian Name: