I/We
assume all risks and hazards incidental to such participation,
including transportation to and from activities, and I/We do hereby
waive, release, absolve, indemnify and agree to hold harmless DasCHE
Spartans Sports Organization, organizers, sponsors, supervisors,
participants, persons transporting my/our child, whether the result of
negligence or any other cause, except to the extent amount covered by
accident or liability insurance. I also understand that DasCHE may not
carry medical insurance, and agree to be fully responsible for any and
all medical expenses in such case.
I/We also agree to accept responsibility for the cost of above medical services.
I/We
do hereby authorize DasCHE Spartans Sports and its representatives to
call an emergency ambulance in case of accident or acute illness, and to
arrange for necessary emergency and surgical care, in case I/We are not
immediately available. I/We give permission for any physician or other
emergency medical personnel to provide medical care at their
professional discretion.
I/We, the parent(s)/guardian(s) of the
above named athlete, hereby give my/our permission and approval to
his/her participation in any athletic event sponsored by DasCHE Spartans
Sports Organization. I/We hereby declare that our child is physically
able to participate in strenuous activity such as competitive athletics
and any practices, tryouts, camps, games, tournaments, or other related
activities.
I/We give permission for my child to receive the
“over the counter” medications listed on this form such as: Ice, Tape,
or Splints Children's Tylenol/ Junior Tylenol/ Adult Tylenol Advil/
Motrin Tablets, Cough drops, Antacid, Topical Anti-histamine Cream,
Benadryl Liquid, Topical Antibiotic Ointment , or generic equivalent of
any of these name brands. Pertinent medical history is also listed on
this form.