Thundercat Sports Camps Information/Waiver Form

Thundercat Sports Camps Information/Waiver Form
Player's full name_____________________________________________ Age____ Date of Birth ____/____/_____
Parent/Guardian full name______________________________________
Full Address ______________________________________________________________________________________________________
Tel. # Home ____________________________ Work __________________________ Cell/Other _________________________________
Person to notify in emergency ___________________________________________________ Tel # ________________________________
Player's health insurance company_______________________________ Player's health insurance policy # ___________________________
Player's doctor's name_________________________________________ Player's doctor Tel.______________________________________
Medical Concerns/Allergies of player (if none please write none, if yes please describe and see the camp director) _____________________
Parent(s) or legal guardian must sign below before player is accepted to participate in the Thundercat Sports camps:
As parent/legal guardian of the child named herein, I hereby represent that the child has been examined by a pediatrician and is
physically fit to participate in the Thundercat Sports camps. I understand there are inherent risks to participating in this athletic
program. I hereby accept responsibility for and agree to pay any and all costs of medical treatment resulting from any injury
suffered by my child as a result of his/her participation at Thundercat Sports camps. I further agree to indemnify and hold
harmless Newton Community Education, as well as Thundercat Sports, and its agents, employees and/or representatives, from
any and all liability, damage, or expense arising out of my child’s participation at Thundercat Sports camps.
In the event that I cannot be reached in an emergency, I hereby give permission for a qualified Thundercat Sports. staff
member, an emergency medical technician, a physician or staff member at a hospital, or any other qualified individual to
administer care and provide any medical treatment deemed necessary for my child.
Signature of parent(s) or legal guardian:
Date: ________________.