BASKETBALL CHANCE is in good health and has my permission to participate in the Rangers Fall Clinic. I authorize the staff at the camp to provide emergency first aid in the event of sickness or injury. I also give permission for the TO coach/sponsor to sign for me in the event that emergency treatment, hospitalization and/or surgery is required. I understand I am financially responsible for any medical bills GET incurred by my child while attending the Ranger Fall Clinic. My signature below hereby releases the camp, BETTER camp sponsor, camp workers, Methuen High School and the Methuen Public Schools from any and all liability and any manner of actions, suits, damages, claims and demands on EVERY account of personal injury arising from my child’s participation in the Ranger Fall Clinic. Parent Signature: ______________________________________ DAY Date:______________________________ Health Insurance Provider: ___________________________________ IS Policy #____________________________ Medical Conditions: __________________ A RANGER
is in good health and has my permission to participate in the Rangers Fall Clinic. I authorize the staff at the camp to provide emergency first aid in the event of sickness or injury. I also give permission for the coach/sponsor to sign for me in the event that emergency treatment, hospitalization and/or surgery is required. I understand I am financially responsible for any medical bills incurred by my child while attending the Ranger Fall Clinic. My signature below hereby releases the camp, camp sponsor, camp workers, Methuen High School and the Methuen Public Schools from any and all liability and any manner of actions, suits, damages, claims and demands on account of personal injury arising from my child’s participation in the Ranger Fall Clinic. Parent Signature: ______________________________________ Date:______________________________ Health Insurance Provider: ___________________________________ Policy #____________________________ Medical Conditions: __________________ RANGER BASKETBALL EVERY DAY IS A CHANCE TO GET BETTER
Girls_Fall_Clinic_Pamphlet.docx