Youth Event Permission Slip

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Emergency Information

 
 
 
 
Alternative Emergency Contact Information

 
 
Health Information

 
 
 
 
 
 
Permission

Please select all that apply.
Please select all that apply.
As the parent/guardian of the listed youth, I hereby authorize any neessary hospital care or medical and surgical procedurs to be performed for my child by a licensed physician or hospital when deemed necessary or advisable by a physician to safeguard my child's health in the event that I cannot be contacted.  I waive my right of informed consent for such treatment.
 
 

Description

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