ذدà،±ل>‏ے <>‏ےےے;ےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےےى¥ءU@ ً؟Fbjbj¬›¬› &&خٌخٌ 9ےےےےےےˆêêêêêêê‏¢¢¢8عوD‏E´6 6 L L L ___ؤئئئئئئ$ùRK´êêà[_ààêêêL L ے:::à"êL êL ؤ:àؤ:J:„:H,êêˆL * ذٌ.$™‹ؤ¢"t ¨0E~ ے$ےˆ‏‏êêêêےêˆ _s:پچS___êê‏‏¤¢$‏‏¢New Milton and District Rugby Football Club Medical Information & Emergency Contact Details Name of player: --------------------------------------------------------- Squad: ----------------------------------- Medical Information Please detail below any important medical information that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes, etc.). Please include details of any medication: ------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------- Family Doctor Name: --------------------------------------------------------------------------------------------------------------------- Address: ------------------------------------------------------------------------------------------------------------------- Telephone Number: ------------------------------------------------------------------------------------------------------ Emergency contact details – to be completed by parent/guardian NameRelationshipHome telephone numberMobile telephone numberI understand that playing rugby has a risk factor and that the Club will take all reasonable steps to minimize that risk. I understand that in the event of any injury or illness the Club will use the above numbers to contact me and I will take reasonable measures to ensure a contact is readily available. I undertake to inform the coach/manager as soon as possible of any changes in the medical circumstances of my child. I am satisfied with the safety of the environment in which training sessions and matches are held. I will ensure that my child has suitable refreshment, suitable kit and protective equipment at each session as advised by the coach/manager. I give permission for a photographer as commissioned by New Milton Rugby Club, to take pictures of my child for use in materials produced by or on behalf of New Milton Rugby Club. Signature of Parent/Guardian Name (Block Capitals) Date It is important that you complete this form as fully as possible and return to your team manager/coach as soon as possible. DATE \@ "dd/MM/yyyy" 26/08/2004 Nick Olsen Issue 3 ,-]طëىھ ¯ ½ ¾ 5uv¶ذL xyغـhŒگ #$./BFٍِىٍçقٍضٍثضçٍئٍ¹°¹°¹°¹°¹ٍئٍئٍ¨ٍ¨ں¨™ٍ hص!s0Jhق(¦mHnHujhص!sUhص!s5پOJQJhص!s5پOJQJmH sH hص!s5پhص!s5پ>*mH sH hص!smH sH hص!s>*mH sH hص!s>* hص!sCJhص!shص!sCJ,OJQJ$,-]^_×طى® ¯ . / ¯ ½ ¾ ;<؛»56uv{ˆ‍‎ûù÷÷÷ٍٍûûىىىêىىىىىىٍٍûننن$If ئ $a$E‏‏‍¶·¸¹؛»ùaùùùù—kd$$If–lض” ض\”ےد …¼&(; ¶7j tàض0ےےےےےےِضےےےےضےےےےضےےےےضےےےے4ض laِ$If»¼½¾؟ہgaaaa$If—kdب$$If–lض”Oض\”ےد …¼&(; ¶7j tàض0ےےےےےےِضےےےےضےےےےضےےےےضےےےے4ض laِہءآأؤإgaaaa$If—kdگ$$If–lض”mض\”ےد …¼&(; ¶7j tàض0ےےےےےےِضےےےےضےےےےضےےےےضےےےے4ض laِإئابةتgaaaa$If—kdX$$If–lض”Vض\”ےد …¼&(; ¶7j tàض0ےےےےےےِضےےےےضےےےےضےےےےضےےےے4ض laِتثجحخدgaaaa$If—kd $$If–lض”ڈض\”ےد …¼&(; ¶7j tàض0ےےےےےےِضےےےےضےےےےضےےےےضےےےے4ض laِدذL yـi‹Œgbbbbbb\\\ ئ &F—kdè$$If–lض”ڈض\”ےد …¼&(; ¶7j tàض0ےےےےےےِضےےےےضےےےےضےےےےضےےےے4ض laِ ŒژڈگCDEF‎ïééç‎‎é ئ ئ &dPئے$1گh°‚. °ئA!°S"°S#گS$گS%°گؤئ$$If–!vh5ض; 5ض¶5ض75ضj#v; #v¶#v7#vj:V–l” tàض0ےےےےےےِِ5ض; 5ض¶5ض75ضj4ضئ$$If–!vh5ض; 5ض¶5ض75ضj#v; #v¶#v7#vj:V–l”O tàض0ےےےےےےِِ5ض; 5ض¶5ض75ضj4ضئ$$If–!vh5ض; 5ض¶5ض75ضj#v; #v¶#v7#vj:V–l”m tàض0ےےےےےےِِ5ض; 5ض¶5ض75ضj4ضئ$$If–!vh5ض; 5ض¶5ض75ضj#v; #v¶#v7#vj:V–l”V tàض0ےےےےےےِِ5ض; 5ض¶5ض75ضj4ضئ$$If–!vh5ض; 5ض¶5ض75ضj#v; #v¶#v7#vj:V–l”ڈ tàض0ےےےےےےِِ5ض; 5ض¶5ض75ضj4ضئ$$If–!vh5ض; 5ض¶5ض75ضj#v; #v¶#v7#vj:V–l”ڈ tàض0ےےےےےےِِ5ض; 5ض¶5ض75ضj4ضœJ@ٌےJNormal!B*CJ_HaJmH phsH tH Z@Z Heading 1$$@&a$5پB*CJ8OJQJ\پaJphے@@@ Heading 2$$@&a$5پ\پPP Heading 3$$@&a$5پCJOJQJ\پ^J:@: Heading 4$@&5پ\پP@P Heading 5$ ئ @&5پ>*\پmH sH uDA@ٍے،DDefault Paragraph FontVi@َے³VTable Normal :Vِ4ض4ض laِ(k@ôےء(No ListLP@ٍLBody Text 2 ئ 5پOJQJ\پ^JH™HBalloon TextCJOJQJ^JaJ4"4Header ئ9r 4 @24Footer ئ9r .)@¢A.Page NumberF &ےےےے,-]^_×طى®¯./¯½¾;<؛»56uv{ˆ‍¶·¸¹؛»¼½¾؟ہءآأؤإئابةتثجحخدذLyـi‹Œژڈگ C D G ;0 ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0 ;0 ;0 ;0 3مبـ` ;0 ;0 ;0 ;0 ےےےے ;0 ;0 ;0 ;0 mè3مبـ ;0 ;0 ;0 ;0 ‎ےہ ;0 ;0 ;0 ;0 ح¨ ;0" ;0" ;0" ;0" بـ`. ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ ;0€ {0 {0›€„ù888;F ‍»ہإتدŒF E";ے•€ًlًً,bً$£ل(jgtL^¤8.-,6ے™ےےےے@ٌےےے€€€÷ً’ًً0ً( ً ًًB ًSً؟ثے ?ًF ےےFھ