Samiksha Sports Pvt. Ltd (“SSPL”) uses video and/or phone calling platform to facilitate psychological and performance enhancement services to be made available through secure online video/audio or telephonic services, which includes but is not limited to counselling, training and consultation sessions, allowing player/child (minor) with the consent of their parents/legal guardians (“I”, “me”, “my”) to consult with SSPL psychologist(s) from the privacy and convenience of the location I choose.

I confirm that I am the parent/legal guardian of the player/child (minor) availing SSPL psychological services and that I am legally competent to consent on behalf of the play- er/child (minor) under the provisions of Law of India. Any person under the age of 18 years is deemed as being a Minor.

1. i understand that SSPL is primarily a sports psychology and performance enhance- ment service provider company but also manages general counselling needs of indi- viduals including minors.
2. I understand that psychological and performance enhancement services include one on one mental training sessions with a sport psychologist. The aim of the sport psy- chologist is to equip player/child (minor) with the necessary mental skills required to play chosen sport and/or to enhance performance and/or bring about development holistically (as applicable to the (minor) player/child).
3. I understand that it is a continuous, gradual, long- term process, with milestones but no deadline. Player/child’s (minor) individual progress pace may differ from others and that diverse mental processes may be worked upon in the sessions continually. It is my duty to assist player/child (minor) in completing and apply the activities/ tech- niques regularly as discussed and recommended by the sport psychologist; but I acknowledge that no results can be guaranteed or assured.
4. I understand that player/child’s (minor) mental training sessions shall involve face to face/ video calling / phone sessions with a SSPL psychologist and with me present at least once (1) every month. It shall include an update on how player/child’s (minor) training is going, how the mental training techniques discussed have been integrated into training by the player/child (minor) and whether they are having any effect, and what to work on next.
5. I understand that the duration of first session is up to 60 minutes maximum. This ses- sion shall involve discussions to know the player/child’s (minor) temperament and understanding the player/child’s (minor) potential from a developmental perspective. After basic information collection, player/child (minor) along with me shall be ex- plained the concept of mental training and its significance in the role of a player/child (minor).
6. I understand that it is very important for the player/child (minor) to be honest and open during these sessions and me to facilitate the same. I agree to assist in carrying out the activities recommended for the player/child (minor) by SSPL psychologist for the development of mental skills; these activities may also include physical activities, worksheets, verbal exercises, etc. that need to be completed at various points of time during the week (this varies depending on player/child (minor) and the nature of player/child’s (minor) chosen sport & activity).
7. I agree to SSPL’s request to send information regarding the player/child’s (minor) schedule, practice matches, tournaments, etc. to help in scheduling appointments and to track mental training progress fitted to player/child’s (minor) schedule. Follow up sessions shall be scheduled on mutual availability or at the discretion of SSPL psy- chologist.
8. I understand that each scheduled session shall typically last for maximum 60 minutes, where player/child’s (minor) psychological challenges shall be identified and worked upon mutually. Maintaining contact with SSPL psychologist in between two scheduled sessions to monitor player/child’s (minor) progress is very important. I agree to in- form SSPL psychologist about the player/child’s (minor) mood states, progress in the sport and behaviours on & off the training areas and encourage the player/child (mi- nor) to do the same OR I agree to inform SSPL psychologist about player/child (minor) mood states, progress in behaviour or areas of general concerns.
9. I understand that all the sessions with player/child (minor) shall be carried out in the presence of parents/legal guardians (unless requested otherwise) and on request along with coach(s) and/or other significant individuals in the player/child’s (minor) life. (SSPL psychologist reserves the right to recommend carrying out one-on-one ses- sions with the player/child (minor) without parental/legal guardian’s presence)
10. I agree that all of the player/child’s (minor) sessions shall be recorded for academic and performance enhancement assistance. I understand and agree to all the play- er/child’s (minor) sessions online or offline audio and/or video being recorded and maybe made into notes. All information in a session as well as any information that has been specifically requested by the player/child (minor) or me on behalf the player/child (minor) to be safeguarded shall be kept confidential. (SSPL shall anon- ymize the data and remove all personally identifiable details from it)
11. I understand and agree that in the circumstances where severe mental or physical distress has been disclosed, or where the player/child (minor) may have demonstrat- ed behaviour, tendency or instances in past, present or future, or as determined by SSPL psychologist that may indicate behavioural traits of self-harm or causing harm to others, SSPL shall not be held liable for disclosing such information or situations to emergency contacts or trusted person (as the case may be).
12. I understand that SSPL is bound to disclose the details to appropriate authorities if any criminal or abusive behaviour has occurred (whether committed by the play- er/child (minor) or inflicted by parents/legal guardians) or has been disclosed to SSPL by the player/child (minor) in the course of the personal sessions. I also understand that SSPL is bound by law to disclose details of the personal sessions in compliance of a court order or inquiry relevant to the matter.
13. I understand and agree that, after obtaining express consent from me, SSPL may share relevant part of the player/child’s (minor) personal session information if it is something that will have to be specifically worked out with the player/child’s (minor) coach or if the player/child (minor) has been referred to SSPL psychological services by the said coach. (Note: the coach(s) are required to sign a confidentiality agree- ment with SSPL before the personal session information is disclosed)
14. I understand that there are risks and consequences from online sessions, including, but not limited to, the possibility that despite reasonable efforts on the part of SSPL and psychologist, wherein the transmission or storing of my personal session infor- mation is disrupted, distorted or lost by technical failures; or the transmission or storage of such information is accessed, interrupted and/or made public by unauthor- ized persons. (SSPL takes all necessary precautions to safeguard the confidentiality of your sessions online and offline)

I confirm that have read and understood and explained to the player/child (minor) the information presented to me through this consent form. I have had the opportunity to consider the information, read, ask questions and gain satisfactory answers.

I understand that the player/child’s (minor) participation in these psychological services is voluntary and that I am free to discontinue it any time on the player/child’s behalf.

I am aware that SSPL reserves the right to discontinue or modify the sessions if and when necessary.

In case of any questions about the information in this Consent Form, please discuss it with SSPL prior to agreeing. AGREEING INDICATES LEGALLY-BINDING AGREEMENT WITH THE INFORMATION SET FORTH IN THIS CONTRACT.

Samiksha Sports Pvt. Ltd (“SSPL”) uses video and/or phone calling platform to facilitate psychological & performance services to be made available through secure online video/audio or telephonic services, which includes but is not limited to counselling, training and consultation sessions, allowing adults (“I”, “me”, “my”) to consult with SSPL psychologist(s) from the privacy and convenience of the location I choose.

I confirm that I am at least 18 years of age and competent to consent under the provi- sions of Law of India.

1. I understand that SSPL is primarily a sports psychology and performance enhance- ment service provider company but also manages general counselling needs of individuals.
2. I understand that psychological & performance enhancement services include one on one mental training sessions with a psychologist. The aim of the psychologist is to equip me with the necessary mental skills required to play my chosen sport and/or to enhance performance and/or bring about my development holistically (as applicable to me).
3. I understand that it is a continuous, gradual, long- term process, with milestones but no deadline; my individual progress pace may differ from others and that diverse mental processes may be worked upon in my sessions continually. It is my duty to complete and apply the activities/ techniques regularly as discussed and recommended by the psychologist; but I acknowledge that no results can be guaranteed or assured.
4. I understand that my mental training sessions shall involve in-person/online/phone- based sessions with a SSPL psychologist at least once (1) every month. It shall include an update on how my training is going, how the mental training techniques discussed have been integrated into training by me and whether they are having an effect, and what to work on next.
5. I understand that the duration of first session is 60 minutes maximum. This session shall involve discussions to know my temperament and understanding my potential from a developmental perspective. After basic information collection, I shall be explained the concept of mental training and its significance for my role as a Player/Coaches/Adult Person.
6. I understand that it is very important for me to be honest and open during these sessions. I agree to carry out activities recommended for me by SSPL psychologist for the development of my mental skills; these activities may also include physical activities, worksheets, verbal exercises, etc. that need to be completed at various points of time during the week (this varies depending on you and the nature of your chosen sport & activity or is based on individual needs).
7. I agree to send information regarding my schedule, practice matches, tournaments, etc. to SSPL to facilitate efficient scheduling of my appointments and to track my mental training progress fitted to my schedule. Follow up sessions shall be scheduled on mutual availability or at the discretion of SSPL psychologist.
8. I understand that each scheduled session shall typically last for 60 minutes maximum, where my psychological challenges shall be identified and worked upon mutually. Maintaining contact with SSPL psychologist in between two scheduled sessions to monitor my progress is very important. I agree to inform SSPL psychologist about my mood states, progress in the sport and behaviours on & off the training areas OR I agree to inform SSPL psychologist about my mood states, progress in my behaviour or areas of general concern for me.
9. I understand that if requested and accepted by me or on recommendation of SSPL psychologist separate or joint discussions shall be carried out with my par- ents/relatives, coaches and any other significant individuals in my life or who could be helpful for me.
10. I agree that all my sessions be recorded for academic and performance enhance- ment assistance purposes. I understand and agree to all my sessions online or of- fline audio and/or video being recorded and maybe made into notes. All infor- mation in a session as well as any information that has been specifically requested by me to be safeguarded shall be kept confidential. (SSPL shall anonymize the data and remove all personally identifiable details from it)
11. I understand and agree that in the circumstance where I may have disclosed severe mental or physical distress, or where I may have demonstrated behaviour, tendency or instance in past, present or future, or as determined by SSPL psychologist that may indicate behavioural traits of self-harm or causing harm to others, SSPL shall not be held liable for disclosing such information or situations to my emergency contacts or trusted person (as the case may be).
12. I understand that SSPL is bound to disclose the details to appropriate authorities if any criminal behaviour has occurred or has been disclosed to SSPL by me in the course of this sessions. I also understand that SSPL is bound by law to disclose details of the personal sessions in compliance of a court order or inquiry relevant to the matter.
13. I understand that SSPL may share a brief summary of my sessions as well as any other information that the SSPL psychologist deems useful, with my parents/relatives and details of the activities/ worksheets may also be explained to the parents/relatives. (SSPL shall obtain my express consent for the same)
14. I understand that SSPL may share relevant part of my personal session information if it is something that will have to be specifically worked out with my coach or if I have been referred to SSPL psychological services by my coach. (Note: The coach(s) are required to sign a confidentiality agreement with SSPL before the personal session information is disclosed)
15. I understand that there are risks and consequences from online sessions, including, but not limited to, the possibility that despite reasonable efforts on the part of SSPL and psychologist, wherein the transmission or storing of my personal session information is disrupted, distorted or lost by technical failures; or the transmission or storage of such information is accessed, interrupted and/or made public by unauthorized persons. (SSPL takes all necessary precautions to safeguard the confidentiality of your sessions online and offline)

I confirm that I have read and understood the information presented to me through this consent form. I have had the opportunity to consider the information, read, ask questions and gain satisfactory answers.

I understand that my participation in these psychological services is voluntary and that I am free to discontinue it any time. I am aware that SSPL reserves the right to discontinue or modify the sessions if and when necessary.

If you have any questions about the information in this Consent Form, please discuss it with us prior to agreeing. YOUR AGREEMENT INDICATES LEGALLY-BINDING AGREEMENT WITH THE INFORMATION SET FORTH IN THIS CONTRACT.