I acknowledge that my application to be a member of Mt Wellington Roller Sports Club (and where applying for inlne hockey membership also a member of IHNZ) is based on the following:

* I consent ot the collection of relvant information required by MWRSC and acknowledge that it may use and disclose such information to Member Clubs, Regional, National and Internationally recognised Sports Orrganisations and Sponsors associated with the MWRSC.  Media Organisations with regard to publishing and/or promotion of events and results and for use in any MWRSC publication;

*I agree to forward the necessary information if required to do so by the New Zealand Sports Drug Agency, and any other relevant Anti-Doping Orangisations, and to comply with any request to achieve practical application of the World Anti-Doping Code;

* I agree to provide details required for outfitting of team uniforms, such information can be passed onto the applicable supplier and/or manufacturer;

*All collected information will be held at the premises of MWRSC;

* I acknowledge my right to access and correct this information;

* agree to abide by the Constitution and Rules ofthe MWRSC and the decisions of the Executive;

* I give my child's permission (where the child is a minor) for my/their image and/or name to be used on the Club website and any associated websites/facebook pages etc.  If I do not give such consent I will expressly notify the team manager and/or club president

* I agree to refrain from any form of discrimination, harrassment or any form of abuse towards others (including but not limited to parents/supporters/team officials/rink staff or any person associated with the sport I am involved in whether on at or off the premises)

*to play with good sportsmanship at all times;

*to refrain from any attitude that could be considered disrespectful and to refrain from the use of abusive language

This consent is given in accordance with the Privacy Act 1993;