Medical Services Permission
Emergency medical care permission to treat when needed.
I authorize the Glens falls City School District coaches and/or other school personnel to obtain any emergency medical care that may become necessary for: (enter student's name)
Your answer
Signature of Parent/ Guardian
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Today's date
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Name of Athlete
Your answer
Name of Parent/ Guardian
Your answer
Address
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Phone number and email address
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Sport and level
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Athlete's date of birth
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Year entered 9th grade
Date of last Physical
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School attended last year
Your answer
I have read and understand the guidelines, procedures, and rules and have reviewed them with my child. I give my (choose one) permission to participate in interscholastic activities.
Parent signature
Your answer
Today's date
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I acknowledge that I have read the guidelines, procedures and training rules and that I agree to comply with the terms and conditions set forth in order that I may participate in any school athletic activities. This form is a binding agreement and covers the athlete the entire calendar year. (Student Please sign below)
Your answer
Today's date
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Signature page I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I also certify that:I understand the questions and statements on this application.I have read and understand the legal information.I understand the penalties for giving false information or breaking the rules.I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
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