Scribd Logo
Upload

Welcome to Scribd!

  • 49 views

    Paintball Release 2008

    Uploaded by

    jackchar
    This document is a permission slip and liability waiver for a student to participate in a CYO paintball event. It collects the student's personal information and health details. It has the parent/guardian consent to the student's participation, transportation, and any medical treatment if needed. It waives the liability of the parish, school, and organizers for any injuries and assigns representatives to act on the parent's behalf in emergencies.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Paintball Release 2008

    Uploaded by

    jackchar
    49 views1 page
    This document is a permission slip and liability waiver for a student to participate in a CYO paintball event. It collects the student's personal information and health details. It has the parent/guardian consent to the student's participation, transportation, and any medical treatment if needed. It waives the liability of the parish, school, and organizers for any injuries and assigns representatives to act on the parent's behalf in emergencies.

    Original Description:

    1 of 2 forms

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a permission slip and liability waiver for a student to participate in a CYO paintball event. It collects the student's personal information and health details. It has the parent/guardian consent to the student's participation, transportation, and any medical treatment if needed. It waives the liability of the parish, school, and organizers for any injuries and assigns representatives to act on the parent's behalf in emergencies.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    49 views1 page

    Paintball Release 2008

    Uploaded by

    jackchar
    This document is a permission slip and liability waiver for a student to participate in a CYO paintball event. It collects the student's personal information and health details. It has the parent/guardian consent to the student's participation, transportation, and any medical treatment if needed. It waives the liability of the parish, school, and organizers for any injuries and assigns representatives to act on the parent's behalf in emergencies.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    Name: ____________________________________________________________________________

    Address: ____________________________________ City:_____________________


    Zip: ______

    Telephone: ( ) ______________ Birthdate: ____ / ______ / _____ Age:______

    School: ______________________________________ Grade: ______

    Parish:____________________________ Religion: ________________________


    ________________________________________________________________________________
    Please note any health problems or conditions we should be aware of:

    Please note any medications that your child is currently taking:

    I/We, the parent(s) and/or legal guardian(s) of the above-named boy/girl give my/our permission for him/her to
    participate in the St. Laurence High School CYO Paintball. By doing so, I/we allow him/her to participate in any and all
    activities, as well as transportation to and from these activities.

    By agreeing to this, I/we hereby waive and release the advisors and moderators, St. Laurence Parish and
    School, the St. Laurence CYO, the Catholic Youth Organization, their organizers and workers, priests and laity, as well
    as anyone transporting my son/daughter to or from any of these events, from all liability for any injury or illnesses
    incurred by my/our son/daughter during this activity scheduled for June 21, 2008.

    In addition, I/we hereby assign and authorize any representative parent or advisor to act for me/us in
    accordance with their best judgment in any emergency requiring medical attention for my/our son/daughter. I/We
    currently have and will continue to maintain my/our own health and medical insurance (as listed below), and will assume
    any and all costs should medical treatment be necessary. I/We authorize the advisors and/or parents to give permission
    for medical treatment for my son/daughter in my/our absence. I/We have listed above any medical condition, mental or
    physical impairment, and/or allergies that should be made known, and I/we have no knowledge of any other physical or
    mental impairment that would be affected by, or affect my/our son's/daughter's participation in the program.
    In case of Medical emergency, I understand that every effort will be made to contact the parents or guardian of the
    participant. In the event that I cannot be reached, I hereby give my permission to the physician selected by the program
    director to hospitalize, secure proper treatment, and to order injection, anesthesia, or surgery if deemed necessary for
    my child as named below.

    We freely give our permission for my/our son/daughter to participate in this activity, and assume all medical and
    health risks associated with not eating during this time.

    _______________________________________ _____________________________________
    Health Insurer Name (MUST be completed) Health Insurance ID Number (MUST be
    completed)

    _________________________________________(Seal) _____________________________
    Signature of Parent/Guardian Date

    You might also like