I am aware that there are
inherent risks and injuries, including death, involved in children’s activities
and sports.In consideration of the
Wadsworth Youth Football League Inc., Medina Youth Football Association,
accepting my child to participate in activities, we the undersigned intend and
agree to be legally bound hereby for ourselves, our heirs, executors, and
administrators, hereby waive and release all and any rights and claims for
damages we may have against the management, the officers, directors, coaching
staff, advisors, assistants or any member of a team or any officer of the WYFL,
MYFA, its representatives, successors and assigns, its affiliated organizations
or sponsors, its employees and all personnel affiliated, including the owners
of the fields or facilities for any injuries to/by me, my son, daughter at any
practice, scrimmage, camp, contest, competition, game, parade or any other meeting.
We, having read the
Parent’s consent and waiver hereby agree to obey all the rules and regulations
of the WYFL, MYFA, Inc and it’s member teams and agree that this right to
participate may be revoked at any time for conduct detrimental to Youth
Football/Cheer as determined by the association.
The patient and others
whose signatures are attached below do hereby consent to any and all medical
and surgical treatments including anesthesia and operations which may be deemed
advisable by his or her physicians and surgeons.The intention hereof being to grant
authority to administer and to perform all and singularly any examinations,
treatments, anesthetics, operations and diagnostic procedures which may now or
during the course of the patient’s care be deemed advisable or necessary.I also agree that the patient when admitted
is to remain in the hospital until his or her physician recommends the
patient’s discharge.
In witness of our consent
and agreement to the matters stated in the preceding sentences, I have
subscribed my signature below.
____________________________________________
Parent
or GuardianDate
*This form isto be used by the coach only after every
effort is made to contact the parent or guardian and only in case of emergency.