Parental Consent Release

First name of Parent or Legal Guardian

Last name of Parent or Legal Guardian

First Name of Youth

Last Name of Youth

Date of Birth for Youth

Address

City

State

Zip

Confirmation

I confirm that I am the parent or legal guardian of the child listed above.

For any situation, I assure that I will be available for the phone call at:

Confirmation

As a parent or legal guardian, I affirm that I have been completely informed all the sport activities that the child; youth will participate. I understand the general structure of the sport activities & programs and do not need to be informed of each and every activity.

Please list any other Conditions/Diseases your child may have:

I hereby voluntarily release, forever discharge the community, the corporation, its officers, directors, employees, volunteer and agents from any and all claims, demands, or causes of action, which are connected with my child's participation in the programs or the use of the equipment and facilities. I agree to pay for any and all medical expenses incurred and give permission to the doctor or health care professional to provide medical care if necessary. The information given in this form is complete and accurate. By signing this form on:

Constent

I confirm that I have fully informed myself of the contents of this Parental Consent and Release Form by reading it before I signed it. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect.

First Name

Last Name

Signature

Parental Consent Release Form