TRACYTON FASTPITCH ASSOCIATION
CONSENT AND MEDICAL RELEASE FORM

I, the undersigned parent/guardian of the named child, do hereby consent to her participation in the Tracyton Fastpitch Association. I recognize that all coaching and supervision is on a gratuitous voluntary basis by persons having no particular or specialized training in child supervision or softball coaching. I further recognize that Tracyton Fastpitch Association is a non-profit organization dedicated to the encouragement of good sportsmanship through organized fastpitch softball and is established to provide the facilities and equipment to enjoy this sports activity.

I also understand that in order for a child to participate in this particular sport, I agree to attend meetings of the Tracyton Fastpitch Association during the sport season, and I volunteer to support this organization by serving on one or more work parties/committees.

I hereby release the coaching and supervisory personnel, as well as the Tracyton Fastpitch Association from any and all responsibility and/or liability for damages and/or injury to the named child, incurred while participating in or going to or from games, practices or meetings.

I further authorize the adult in charge to arrange for any necessary emergency medical care in the event we cannot be reached immediately. This medical or dental care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependant.


PLAYERS NAME:________________________PARENT/GUARDIAN NAME: _________________

HOME PHONE:________________CELL PHONE______________WORK PHONE_______________

FAMILY PHYSICIAN______________________________PHYSICIAN PHONE_________________

EMERGENCY CONTACT__________________________EMERGENCY PHONE________________

EMERGENCY RELATIONSHIP_________________________________________________________

ANY KNOWN MEDICAL CONDITIONS_________________________________________________

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