Activity Consent Form / Waiver
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Activity Consent Form / Waiver
Activity Consent Form and Approval by Parents or Legal Guardian
First name, middle initial and last name of participant __________________________________
Address(residential not PO Box): __________________________________________
City:___________________ State: ______ Zip: ____________
Birth date (month/day/year): ________ Age during activity: ________________
Has Approval to participate in: ________________________ From: __________ to ____________
Please check on:
___ Without Restrictions
___ Special Considerations or restrictions: ____________________________________________
Hold Harmless Agreement
I understand that participation in the activity involves a certain degree of risk. I have carefully considered the risk involved and have given consent for myself or my child to participate in the activity. I understand that participation in the activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release Southcom Airsoft, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.
In case of an emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant's parents or guardian, and/or determination of the participant's ability to continue in the program activities.
Participants signature: _________________________________________ Date: ____________
Parent/Guardian printed name: ___________________________________________
Parent/Guardian Signature:_____________________________________________ Date: ___________
Emergency Contact (Name, Phone, Relationship to Participant): ___________________________________
Second Contact (Name, Phone, Relationship to Participant): _______________________________________
First name, middle initial and last name of participant __________________________________
Address(residential not PO Box): __________________________________________
City:___________________ State: ______ Zip: ____________
Birth date (month/day/year): ________ Age during activity: ________________
Has Approval to participate in: ________________________ From: __________ to ____________
Please check on:
___ Without Restrictions
___ Special Considerations or restrictions: ____________________________________________
Hold Harmless Agreement
I understand that participation in the activity involves a certain degree of risk. I have carefully considered the risk involved and have given consent for myself or my child to participate in the activity. I understand that participation in the activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release Southcom Airsoft, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.
In case of an emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant's parents or guardian, and/or determination of the participant's ability to continue in the program activities.
Participants signature: _________________________________________ Date: ____________
Parent/Guardian printed name: ___________________________________________
Parent/Guardian Signature:_____________________________________________ Date: ___________
Emergency Contact (Name, Phone, Relationship to Participant): ___________________________________
Second Contact (Name, Phone, Relationship to Participant): _______________________________________
Re: Activity Consent Form / Waiver
For those who havent done one of these, do we print it? d:
Cyborg- Sgt
- Posts : 106
Join date : 2010-01-31
Age : 30
Location : Niceville, FL
Re: Activity Consent Form / Waiver
Yes tom. yes u do.
TheTerminator- 1stSgt
- Posts : 200
Join date : 2010-01-30
Age : 27
Location : Niceville, Florida
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