2017 Medical Treatment Release
Archery Training Center, Inc.

(The following policy reflects our concern for your family's physical welfare. Please read it carefully and sign below before your Indoor 2 class. We cannot admit you or your family to the Archery Training Center classes, tournaments, and activities without your signature.)

As self/parent/guardian, I assume all responsibility and on behalf of myself and my heirs, executors and administrators waive any claim for compensation or damage for injury or illness my family or I incur while at Archery Training Center, Inc. or otherwise in the care or under the instruction or supervision of its instructors or coaches, and hereby agree to indemnify and hold harmless Austin JOAD Archers, Archer Target Archers, as part of Archery Training Center, Inc., its instructors and coaches against any and all claims which may arise from our participating in this program. I also understand that Archery Training Center, Inc. does not carry medical insurance, and that I am responsible for my family's and my own medical insurance and healthcare. I realize that archery is a potentially dangerous activity, and knowing this I agree to my family's and my participation in the archery activities.

In the event that I cannot be reached or am unable due to injury or illness to make arrangements for emergency medical attention at the time of illness or accident, I hereby authorize Archery Training Center, Inc. to call 911 to provide urgent care to members of my family or to me.

My signature below indicates that I have read, understand the above policy and agree to comply with its provisions. Parent(s)/Guardian(s) must sign for junior archers under the age of 18.

If there are more than one junior archer, please fill in multiple names.

Health issues:
If you or someone in your family who will be participating in archery have any health issues that require special attention or would be of concern when engaging in this sport, it is important that we know, so we can react more appropriately if something happens.
Please tell us what they are, and what additional treatment would be necessary.
In the event that you or someone in your family has health issues that may need special attention while participating in or observing our archery classes, practice session, or tournaments, we require a member of your family who can render or request immediate and necessary treatment to remain in the range at all times with the person.
We also reserve the right not to instruct you or allow you to shoot in the range or classes if you are on blood-thinning medication, as bruising of the arm often occurs when practicing archery, and this can result in sudden, uncontrollable bleeding for those on this medication. It is for your own protection!

Anything you'd like to tell us?
It is very important and helpful for us as instructors and coaches to know of any medical, physical, mental, emotional, sensory, attention, language or learning challenges the archer may have, so that we can coach more appropriately.

Junior's first and last name
Your answer
Parent(s)/Guardian Signature
Your answer
Parent(s)/Guardian first and last names
Your answer
Junior's home address
Your answer
Junior's home phone no.
Your answer
Parent's/Guardian's cell phone no.
Your answer
Alternate emergency contact name
Your answer
Alternate emergency contact phone no.
Your answer
Do you or someone in your family who will be participating in archery have any health issues that require special attention or would be of concern when engaging in this sport?
If so, please tell us what they are:
Your answer
What additional treatment could be necessary?
Your answer
Is there anything you'd like to tell us to make your lessons more effective?
Your answer
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