West End – Montague Road

I hereby grant permission to Brisbane Central Futsal/ Fire FC representatives, to take and use photographs and/or digital images of me or my child for use in:

1 – Media releases, media articles – including newspapers, radio, television, printed publications and/or educational materials relevant to Brisbane Central Futsal/ Fire FC,
2 – Electronic publications and communications such as Brisbane Central Futsal/ Fire FC or affiliated  social media pages  and websites,
3 – I agree that my or my child’s name and identity may be revealed in descriptive text or commentary in connection with the image(s),
4 – I authorise the use of these images without compensation to me.

All negatives, prints, digital reproductions shall be the property of Brisbane Central Futsal/ Fire FC.

  Yes

  No

1. We will not allow harm to be caused to children and young people.
2. We will not cause harm to children and young people in our care.
3. We will eliminate, or else minimise, harm to children or young people in our care.
4. We will support children and young people who are victims or potential or suspected victims of harm.
5. We will report harm to children and young people to relevant authorities, regardless of who has caused the harm.   

In the running of a typical Brisbane Central Futsal/Fire FC event, the following forms of harm are most likely to occur:
1. A player running and tripping, causing physical harm.
2. A player getting hit by a ball, causing injury.

Brisbane Central Futsal/ Fire FC has appointed nominated persons (Maria Contoudios, Efraim Ferdinand) to handle incidents involving children and young people.  All incidents (actual or perceived) are to be reported directly to the nominated person either verbally or in writing and the nominated person must ensure the confidentiality of the complainant and other parties (e.g. child or young person and the alleged perpetrator).

The nominated person will evaluate the incident and respond with one or more of the following actions:
• Make changes to a service or activity and allow it to proceed or suspend or permanently stop it.
• Remove or replace the volunteers or employees who are providing or conducting the service or activity, subject to further investigation.
• Facilitate appropriate medical, counselling or other assistance to children and young people.
• Report the matter to relevant statutory or regulatory authority such as the Department of Child Safety or the Queensland Police Service. 
• The nominated person will record incidents reported to him/her, the action taken and other relevant details in the Incident Register (the Incident Register will be kept securely on the premises and only able to be accessed by authorised personnel).

Brisbane Central Futsal/ Fire FC will notify the parents/guardians of the children and young people about the incident if it is a major incident only (any minor injury or fall will be dealt with by the coach or relevant staff). Parents will be notified during pick up and where practicable, extend to them the appropriate level of support. Brisbane Central Futsal/ Fire FC will act fairly and reasonably towards all parties involved and will cooperate with relevant statutory or regulatory authorities in the event of an investigation. Brisbane Central Futsal/ Fire FC will put in place mechanisms such as an active monitoring program (in addition to implementing corrective measures) to ensure the incident does not reoccur.

I wish to register myself/my child in the Fire FC School Program herein after referred to as the “Program”). I hereby:

– Understand that there are potential and unforeseeable risks that may be associated with the program, which may result in injury whilst participating.   

 – Understanding the potential risks associated with the program, I agree to indemnify, release and discharge the Brisbane Central Futsal/ Fire FC and/or partners from all liability for any injury, loss, damage or costs/expenses caused, arising or incurred through my child’s participation.   

 – Acknowledge that Brisbane Central Futsal/ Fire FC & its staff/volunteers will take all reasonable care during the course of the program & I will not hold them responsible for any damage/loss to property and/or accidents. 

 – Authorise Brisbane Central Futsal/ Fire FC and its employees/volunteers to act on my behalf should I/my child require medical attention during the course of the program and indemnify them from any legal action in the cause of rendering myself/my child the assistant.

–  Confirm to the best of my knowledge that I/my child does not suffer from any medical condition other than those listed above.