Individual Registration Form - Airtel Africa

player registration form
(Passport size photos)
Name of Player: _________________________________________ Date of Birth: __________________
(Full Names)
Name of Team: ____________________________ Name of School: ______________________________
(You are currently playing for)
(You are attending)
Gender: Boy Girl
(Please tick one)
Position: ______________________________________________________________________________
(What position do you play?)
Home language ________________________________________________________________________
________________ ________________ ______________
Place of birth Country of birth Nationality
Physical address ________________________________________________________________________
____________________________________________________________________________________________________________________________
Postal Code: ___________________________________ City: ___________________________________
Type of Identification Document: __________________________________________________________
Identification Document Number: __________________________________________________________
Issuing Authority: _______________________________ Date of Issue: ___________________________
Your phone number: _____________________________ Additional phone number: _________________
E-mail-address: _________________________________________________________________________

player registration form
GENERAL CONDITIONAL AND RULES OF PARTICIPATION
These conditions for participation in the Airtel Rising Stars Football Tournament have to be signed by your
parent/legal guardian and yourself. It concerns your personal responsibilities as part of your touring party,
your health condition as well as the permission of your parent/legal guardian to participate.
Kindly initial each page and sign as per requirement.
PARENT’S DETAILS:
Parent’s Family Name: ____________________________________________________________________
Parent’s First Name: ______________________________________________________________________
Parent’s Identification Number: _____________________________________________________________
Parent’s phone number in case of an emergency:______________________________________________
Parent’s regular cell phone number:_________________________________________________________
Parent’s phone work number: _______________________________________________________________
BIRTH CERTIFICATE SIGNED BY PARENT/LEGAL GUARDIAN
First name and last name____________________________________________________________________
Physical address _________________________________________________________________________
Post code/city/country ____________________________________________________________________
Phone number __________________________________________________________________________
Country of birth/place of birth _____________________________________________________________
Nationality ______________________________________________________________________________
Gender: M F

player registration form
IMPORTANT! Please make sure that your child carries an identification card/document with him/her on
his/her day of participation!
I hereby give consent to my child ________________________ for participation in the Airtel Rising Stars
Football Tournament and agree to take all responsibility to ensure that my child will follow the rules of
participation, set out below.
Legal Guardian Father Mother Guardian
First name and family name
_______________________________________________________________________________________
Phone number (private and at work)
_______________________________________________________________________________________
Mobile phone (in emergencies)
_______________________________________________________________________________________
Address
_______________________________________________________________________________________
E-Mail Address__________________________________________________________________________
Signed by Guardian in ________________________________ on ________________________________
In the event of an emergency, please indicate your name and phone number that you and two other
authorized persons may be reached on:
Father’s Name: __________________________________________________________________________
(H)Phone: _____________________________________ (W) Phone: _____________________________
Mobile _________________________________________________________________________________
Mother’s Name: __________________________________________________________________________
(H)Phone: ______________________________________ (W) Phone: _____________________________
Mobile _________________________________________________________________________________

player registration form
First Aid
In the event of an emergency, I authorize the staff of Airtel or the Emergency Medical Technicians to provide
any first aid care deemed necessary for my child.
Signature____________________________________ Date _____________________________________
Emergency Care
In the event of an emergency in which I cannot be reached, the physician listed above or a local hospital
are hereby authorized to provide any emergency care deemed necessary for my child.
Signature____________________________________ Date _____________________________________
Hospitalization
In the event of an emergency that should require hospitalization, I authorize the staff of Airtel or the
Emergency Medical Technicians to provide any first aid care deemed necessary for my child.
I further affirm that I have ensured that my child has travel and medical insurance in connection with his
or her participation in the Airtel Rising Stars Football Tournament.
Health Record Transfer
In the event of an emergency, I hereby authorize the transfer of my child’s health record to the local hospital.
Signature____________________________________ Date _____________________________________

player registration form
RULES OF PARTICIPATION
These rules and regulations (these” Rules”) apply to participants of full age accordingly and shall be
adhered to completely.
This tournament shall be known as the Airtel Rising Stars Football Tournament.
1. In my capacity as Guardian, I confirm that I will advise my child in his/her capacity as participant in
the Airtel Rising Stars Football Tournament to abide by the Rules regulating his/her participation in this
program. I am informed that any infringement of these rules may cause withdrawal of his/her admission
as participant by Airtel.
2. In my capacity as Guardian, I acknowledge that Airtel and its suppliers bear no responsibility whatsoever
for any cancellation or changes to the Airtel Rising Stars Football Tournament howsoever caused. I accept
all changes to the program and waive the right to make objections and to file a suit against Airtel, its
directors, executives, authorized agents, employees and representatives from any and all liability claims
and demands of whatever kind or nature, which arise or may arise from participation of my child in the
Airtel Rising Stars Football Tournament, during the activities of the program or while travelling to and
from the event, unless they are caused by gross negligence.
3. I hereby indemnify Airtel, its directors, institutions, authorized agents, employees and representatives
from any and all liability for losses to any third party resulting from my negligent conduct or omission
during participation of my child in the Airtel Rising Stars Football Tournament.
4. I declare that my child is sufficiently prepared for his/her participation in all activities of the Airtel Rising
Stars Football Tournament. The participation of my child in activities and events organized or sponsored
by Airtel is completely voluntary.
I have been informed that certain risks relating to personal security and to the belongings of my child,
which are inherent to his/her participation in activities and events organized or sponsored by Airtel, cannot
be eliminated. I am willing and agree to assume responsibility for the inherent risks which may include
injuries, illness, and damage to property or losses. I have arranged for the enclosed medical certificate to
be completed correctly.
5. I agree that my child’s participation in the Airtel Rising Stars Football Tournament is conditional upon
the opinion and consent given by a reputable doctor as agreed by Airtel.
6. I agree that any Participant adjudged by Airtel (in its sole discretion) as displaying exceptional talent,
shall be required to attend a soccer clinic in a country and time to be decided by Airtel and the Participant
hereby agrees to be an Airtel Football Ambassador for a period of two years after successful completion
of the soccer clinic.

player registration form
7. I grant permission to Airtel, its subsidiaries, associated companies to use, broadcast, publish and exploit
the name of my child in any medium free of charge, as well as his/her voice, statements, short-takes or
interviews in form of quotations, pictures, drawings, visual representations, video, or film shots/pictures
obtained during the Airtel Rising Stars Football Tournament in perpetuity. This includes the use of this
material in the international media for the purpose of advertisement, promotion, publication, business,
marketing, Public Relations and media coverage. I cede any right to review or approve publications of the
final product or texts, including their purpose of use, which is obtained on the basis of the consent I hereby
give. I acknowledge that Airtel is going to protect these personal rights in all respects.
8. I also acknowledge that I have informed my child that no drinking of any alcoholic beverage nor any
substance use or misuse will be permitted while participating in this tournament and that should my child
be found participating in such activity, Airtel and its agents have had the right (in their absolute discretion)
and my permission to expel my child from the tournament.
9. These Rules apply in addition to any possible conditions of local programs or events, within which
framework the Airtel Rising Stars Football Tournament is going to take place.
10. These Rules shall be governed by, and construed in accordance with, the laws of ___________________
[COUNTRY]. Any dispute arising out of, or in connection with, these rules of participation shall be resolved
amicably by the parties. In the event the parties are unable to resolve their dispute amicably, then the
dispute shall be referred to arbitration [insert local arbitration body]. The number of arbitrator shall be
one and the language of the proceedings shall be [English][French]. The place of arbitration shall be
___________________ [CITY in COUNTRY].
11. I agree that I shall be solely responsible for all the costs incurred by my child in connection with
participating in the Airtel Rising Stars Football Tournament including, but not limited to, attending the
Airtel Rising Stars Football Tournament and travel costs other than those costs incurred in connection
with a National tournament which shall be borne by Airtel.
________________________________________________________________________________________
Signed by Guardian in ________________________________ on ________________________________
________________________________________________________________________________________
Signed by Participant in_______________________________ on ________________________________

player registration form
We would like to take this opportunity to congratulate you for taking part in the Airtel Rising Stars Football
Tournament.
For good and valuable consideration, the receipt of which you hereby acknowledge, you agree as follows:
a) You understand that you are not and will not be an employee of Airtel and that you will not receive
compensation or benefits from Airtel other than those described above, and that Airtel is not responsible for
obtaining insurance or other compensation covering accident or injury to you arising from your participation
in the tournament. Airtel is also not responsible for any personal property you may leave behind;
b) You agree that you will keep all information that you may obtain concerning the operation of the
Airtel Rising Stars Football Tournament, including, without limitation, information about Airtel Rising
Stars Football Tournament finances and Airtel’s contracts with third parties, strictly confidential, and not
disclose any such information to any individual or entity under any circumstances without Airtel’s prior
written approval;
c) You, on behalf of yourself, your heirs, executors and administrators, hereby:
(i) release and discharge Airtel, its parent, subsidiary and related companies, and the officers, directors,
employees, representatives and agents of the foregoing, from and against any and all liability, losses,
claims, demands and causes of action for personal injury and other damage that may be sustained by you
in connection with your provision of services for the Airtel Rising Stars Football Tournament; and
(ii) consent to and authorize the ongoing use and reproduction by Airtel or anyone authorized by Airtel of
any and all photographs or that may be taken of you in connection with your provision of services for the
Airtel Rising Stars Football Tournament for editorial and promotional purposes in all media now known
or hereafter developed, throughout the World.

player registration form
If this letter accurately reflects your understanding, please sign in the space provided below.
ACCEPTED AND AGREED TO:
Print Name: _____________________________________________________________________________
Date: __________________________________________________________________________________
Signature: ______________________________________________________________________________
Date of Birth: mm/dd/yyyy _________________________________________________________________
Address: ________________________________________________________________________________
PARENT/LEGAL GUARDIAN:
I represent that I am the parent/guardian of the above-named person.
I hereby consent to the foregoing on his/her behalf.
Print Name: _____________________________________________________________________________
Date: ___________________________________________________________________________________
Signature: ______________________________________________________________________________