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Athlete’s Name:__________________________(hereinafter “child” PARENTAL CONSENT FOR TREATMENT OF CHILD: Parental consent for the treatment of minors in the case of illness or accident. Parental permission must be obtained before medical treatment can be rendered to persons under 18 years of age. The following consent form should be signed by the parent or guardian so that indicated care might be given with no unnecessary delay. No major procedures will be performed, except in extreme emergency, without parent being notified and fully informed. If the form is not signed, it will be interpreted as a refusal of permission.

 

I give permission to the physician’s office, hospital, or clinic to carry out such emergency diagnostics and therapeutic procedures as may be necessary for my child, and in the physician’s absence for the nurse on duty to render emergency care in line with standing order.

 

_____________________________________________ Parent/legal guardian

Signature                                                                  Date                                                           

 

 

HOLD HARMLESS AGREEMENT In consideration of the Hart Beat Running Club allowing my child to participate and compete with the Hart beat Running Club program, I intend to be legally bound for myself and I intend to legally bind “child” by executing this agreement. I hereby waive or give up any right I or “child” may have to file suit against the hart Beat Running Club, its coaches, parent volunteers, or any other person, organization, or entity assisting the hart beat Running Club in its track, cross country or other running program (hereinafter collectively Hart beat Running Club. The purpose of this agreement is to assure the Hart Beat Running Club that in the event “child” is injured or damaged as a result of his/her participation with the Hart Beat Running Club, I and/or “child” will not hold Hart beat Running Club responsible or liable and I promise on behalf of myself and “child” that I and/or “child” will Hart Beat Running Club for any damages or injuries to “child”.

 

_____________________________________________ Parent/legal guardian

Signature                                                                  Date                                                            

 

 

CONSENT TO SIGN ENTRY/WAIVER FORMS Parental consent is given to permit the coaches and/or the officers of the Hart Beat Running Club to sign an entry/waiver form for entry of my child into a track & field competition, cross country meet, or other running event.

 

_____________________________________________ Parent/legal guardian

Signature                                                                  Date