Fillable Sharp Medical Release Form printable pdf download

Sharp Medical Release Form

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Medical Release Form

Medical Treatment & Release of Liability

Each Participant Must Sign and Complete This Form for each event.

Forms Must Be Turned in at Registration with a Medical Release Roster

I, the undersigned parent or legal guardian, grant permission for my daughter/son

__________________ hereinafter referred to as “participant”, to participate in the SHARP

International. In order that participant may receive the necessary medical treatment in the event

of an injury or illness.

I herby agree to any such medical treatment and hold SHARP

International and its representatives harmless in the exercise of this authority. I acknowledge

and understand that participant may sustain serious, catastrophic physical injury, illness and/or

death by participating in the SHARP International. I further assume the risk of such injury,

illness and/or death and agree to participation.

I agree to indemnify and hold harmless the school/park and SHARP International including but

not limited to all representatives, all staff personnel, and all administrators and/or the theme park,

for any injury, illness, and/or death sustained by participant during the course of the competition.

I further release SHARP International from any medical and legal cost which may arise due to

injury, illness and/or death sustained by participant.

PLEASE CIRCLE THE EVENT THAT YOU WILL BE PARTICIPATING IN

School Hosted Event

Knott’s Berry Farm

Magic Mountain

Raging Waters

Hawaii World Finals

College Hosted Event

Las Vegas Cashman Center

Private Day Camp

Camp of Champs Tour

Participant’s Signature

Parent/Guardian Signature

School/Studio:

Age:

Date:

Phone number:

Work/Emergency Phone:

Address:

City, State, Zip Code:

Insurance Co.:

Policy#:

Known Medical Conditions: (Seizures, Epilepsy, Diabetes, Etc.:

Email Address:

Please list on the backside of this form, any medication this participant is allergic to or is currently

taking. If participant is on any medication, please make sure they bring their medication and take

the prescribed dosage needed.

Bring This Paper to the Event, Please DO NOT FAX or MAIL this form to us

Sharp Medical Release Form

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