Air Blair Athletics - Parent Permission and Waiver

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Child's Name

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Parent's Name (First & Last)

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In Case of Emergency Contact

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Does your child have any allergies or medical conditions? If yes, please describe

Health Care Provider or Family Physician

LIABILITY WAIVER: I hereby give my child permission to participate in Air Blair Athletics activities. I declare that I have checked with a certified physician and that my child is in good physical condition. I am aware that participation in Air Blair Athletics Programs have some inherent risks and injury can occur. On rare occasions these injuries can be serious. I hereby give the staff of Air Blair Athletics permission to render such medical and hospital care as, in their judgment, may seem advisable for my child. I also hereby state that we have adequate medical coverage and will not hold the staff of, location of or sponsorship of Air Blair Athletics liable for any injuries incurred during this activity. I, the parent/guardian, assume the risk of all injury and agree not to sue Air Blair Athletics or facilities, employees, coaches, assistant coaches, agents, or volunteers for any and all injuries caused by or resulting from participating in Air Blair Athletics activities. In addition, by adding my name below, I also authorize the use of pictures of the above-named participant to be posted on the Air Blair Athletics website or advertising media published by Air Blair Athletics.

ESign with Parent's Name

Air Blair Athletics - Parent Permission and Waiver

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