Participant Consent and Indemnity form

Each team member must fill in the form below. If you are under 18 years old, you must obtain Parent / Guardian permission.

Purpose of collection: For people participating in the Beaches Young Filmmakers to provide their consent and agreement to the competition rules and guidelines
Intended recipients: Council staff
Supply: Mandatory for purposes of providing participant consent and indemnity.
Access/Correction: Contact the Customer Service Team to access or correct this information on 1300 434 434
Storage: Northern Beaches Council, 1 Belgrave Street, Manly NSW 2095

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Team member details

Team name

Full name of partipant

Date of birth

Address

Address 2

City/Town

Postcode

Mobile number

Next of kin (in case of emergency)

Name

Relationship

Contact number

Contact number
	Contact number	Item weight

more items

I have read and understood the above

Participant's name

For a participant under the age of 18, name of parent or guardian

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