BFHS Health and Contacts Form

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Name *

Birthdate *

YYYY

Grade (2026-2027) *

6th

7th

8th

9th

10th

11th

12th

Guardian 1 Name & Phone Number *

Guardian 2 Name & Phone Number *

Additional Contact Person Name & Phone Number *

Primary Email Contact *

Allergies (Including food, medication, stings). List and describe reaction. Put N/A if it does not apply. *

Does the student have a history of: (check all that apply) *

Asthma

Heart Defect/Disease

Seizures

Diabetes

Bleeding Disorder

NONE of the above

Required

Please explain health conditions if checked above. Put N/A if it does not apply. *

Does the student have any physical limitations? If yes, please explain. Put N/A if it does not apply. *

INSURANCE LIABILITY WAIVER

Please read this form carefully and be aware that in registering yourself or your minor child/ward for participation in the Big Foot Recreation District program(s), or Big Foot High School Summer School you will be waiving and releasing all claims for injuries you or your child/ward might sustain arising out of the program(s).

I recognize and acknowledge that there are certain risks of physical injury to participants in programs and I agree to assume the full risk of any such injuries, damages or losses regardless of severity which I or my child/ward may sustain as a result of participating in any activities connected or associated with any such program.

I agree to waive and relinquish all claims I or my child/ward may have as a result of participating in the program against the Big Foot Recreation District, the Big Foot Union High School District and its officers, agents, servants and employees. I do hereby fully release and discharge the Big Foot Recreation District School District and its officers, agents, servants and employees from any and all claims resulting from injuries, damages and losses sustained by me or by my child/ward and arising out of, connected with, or in any way associated with the activities of any of the program(s).

I have read and fully understand the above release and waiver form.

In the event of a medical emergency, 911/Emergency Medical Services will be called and student will be transferred to the nearest medical facility.

I understand the arrangements and believe that the necessary precautions and plans for the care and supervision of the children during the Summer Class will be taken. Beyond this we will not hold the school or those supervising the trip responsible.

I have read and understand the insurance liability waiver and provided all accurate information listed above.

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