Parent(S) / Guardian(S) /The Principal / Executives and Team Management

CHAIRPERSON: B Du PLESSIS

MARCH 18, 2017

GENERAL INFORMATION: HIGH SCHOOLS / LSEN

FOR ATTENTION:

PARENT(S) / GUARDIAN(S) /THE PRINCIPAL / EXECUTIVES AND TEAM MANAGEMENT

Dear Colleagues

The Western Cape Athletics Team will participate at the South African Schools Athletics Track & Field Championships for High Schools to be held at the Kings Park Athletic Stadium, Durban, Kwazulu Natal on 29,30,31 March and 01 April 2017.

It should be noted that the team will travel to Durban on the morning of Tuesday 28 March 2017. Athletes

who wish to travel on their own must duly apply in writing to the Secretary, Mr. Deon Wertheim

[ ] Parents should however note that the team must stay together, if an athlete refuse to stay with the team, participation will be withheld and such an athlete will be withdrawn from the competition. Athletes travelling on their own MUST report to the team on Wednesday 28 March at 14:00 at the Garden Court Hotel in Durban.

No exceptions will be made.

DEPARTURES: Bellville Stadium 12H00

Community Hall, Paarl 13H00

Worcester Mall 14H00

Garden Route Mall, George 18H00

Total Garage, Beaufort West 20H00

Due to a substantial contribution by DCASS we are able to keep the cost down and the following monies are due by athletes.

Travelling with the team: R3000.00. Travelling on your own: R 2500. [Excluding attire ]

Monies must be paid in before or on Friday 24 March 2017.

ACCOUNT NAME WESTERN CAPE SCHOOLS ATHLETICS

BANK: ABSA

BRANCH: 334210 PAARL

ACCOUNT NUMBER: 4059294250

REF: NAME OF ATHLETE

PLEASE MAIL PROOF OF PAYMENT TO:

Yours truly

Llewellyn Arendse - 074 867 2091

If you need any further information, contact Jannie Nel (SWD) -083 265 0798 / Clarence Combrinck (Boland)- 082 775 8910 / Cedric Cyster (WP) -078 503 7866

Rejane Willemse 0839591369 (LSEN)

CHAIRPERSON: B Du Plessis

MARCH 18, 2017

INDEMNITY FORM

I ______(Full name and surname of parent / guardian)

hereby give consent for my daughter / son ______(full name(s) and surname) to participate in the South African Schools Athletics Track & Field National Championships to be held at the Kings Park Athletic Stadium

I am aware that the WC Schools Athletics accept no responsibility for any loss, injury or damage that the person or property of my child may sustain whilst engage in any activity, and I waive my right that I have, in so far as I am able, and my child may have to claim compensation against SASA and WC organisers or other members in respect of any loss, injury or damage incurred whilst engaged in the Championship howsoever arising and whether as a result of negligence or otherwise and I indemnify them against all claims of such activity.

I am aware that the attendance at this excursion and the activities which may take place during this excursion may hold the possibility of physical injuries. I accept that all reasonable precautions will be undertaken to ensure the safety and welfare of my child.

To the best of my knowledge, my child is in good health and physically able to participate in the said Championship. I / We, as parent(s) / guardian(s), hereby give permission to the Team Management or their representatives, to authorize medical care / treatment should it be required for my child. I / We request the Team Management to note the following:

…………………………………………………………………………………………………………..Please mention information concerning your child’s health, allergies, etc. and / or activities in which he / she may participate.)

Signed at this 18th day of March 2017 at Daljosaphat in Paarl

Signature of Mother / Father / Guardian: ______Cell/Contact No ______

CHAIRPERSON: B Du Plessis

MARCH 18, 2017

MEDICAL QUESTIONNAIRE - LEARNER / EDUCATOR INFORMATION

NAME: ______

SURNAME: ______DOB______

NAME OF SCHOOL: ______TEL: -______

NAME OF PARENT / GUARDIAN: ______

HOME ADDRESS: ______

HOME TELEPHONE: ______WORK: ______

CELL PHONE: ______

Do you belong to a Medical Aid? YES / NO

NAME OF FUND: ______

MEDICAL AID NUMBER: ______

FAMILY DOCTOR: ______

Is your child allergic to any food? YES / NO

Is your child allergic to any medication? YES / NO

If yes, please give details: ______

Signature of Parent / Guardian: ______

MARK WITH AN X

FOOD REQUIREMENTS: / COSHER FOOD / HALAAL FOOD