Nmx Paretnal Permission For Travel printable pdf download

NMX Parental Permission for Travel, 

Medical Release, & Waiver Form 

I (We), the undersigned parent(s) of ____________________________________________________, a minor do 

hereby give NMX Sports permission for my Child  (named above) to participate in the NMX Trip 

and the following specific activity conducted during the Trip:__________________________________________.  

Properly maintained and insured vehicles or rented buses will be used to transport participants. 

I (We), the undersigned parent(s) of ____________________________________________________, a minor do 

hereby authorize the Trip Leaders of NMX Sports as agent(s) for the undersigned to consent to any 

x‐ray examination, anesthetic, medical or surgical diagnosis or treatment, & hospital care which is 

deemed advisable by, & is to be rendered under the general or special supervision of any position 

or surgeon, licensed hospital whether such diagnosis or treatment is rendered at the office of said 

physician or at the said hospital. 

It is understood that this authorization is given in advance of any specific diagnosis, treatment or 

hospital care being given in advance of any specific diagnosis, treatment, or hospital care being 

required but it is given to provide authority & power on the part of aforesaid agent(s) to give 

specific consent to any & all such diagnosis, treatment, or hospital care which the aforementioned 

physician in the exercise of his best judgment may deem advisable. 

I (We), the undersigned parent(s) of ____________________________________________________, a minor do 

hereby agree to hold NMX Sports and any and all sponsors harmless for any injury or medical or 

other health care problem my Child may incur during my Child’s participation on the Trip and the 

activity.  I agree to pay all medical cost related to any injury or illness that my Child may incur 

during my Child’s participation in the Trip and the activity.  I further agree that NMX Sports shall 

not be responsible for payment of medical services for my Child and acknowledge and agree that 

any NMX insurance that may exist does not cover my Child’s medical costs. 

Parent/Guardian Signature: __________________________________________ Date: ____________________________ 

NMX Representative: __________________________________________________ Date: _____________________________ 

Nmx Paretnal Permission For Travel