GASO BDT Medical Release, Waiver Form and Social Media Release
Medical Release, Waiver Form and Social Media Release
Email address *
Athlete Name *
Gender *
Birth Date *
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DD
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Address - Ex: 3534 Silverstone Dr. Dallas, Texas, 75225 *
Parent/Guardian Name *
Parent/Guardian #1 Cell *
Email *
Emergency Contact (other than Parents/Guardian) *
Emergency Contact Phone *
Health Insurance Company *
Policy Number *
Please supply any other medical information such as allergies, medications or pre-existing conditions: *
Waiver: I, the parent/guardian of the individual, a minor (the "athlete"), do hereby permit the athlete to participate in GASO BDT course and certify that the athlete's physical condition is sufficient for full participation. I understand that the athlete's participation in GASO BDT involves an element of risk and a possible danger of accidents and illnesses. I also understand that the athlete's participation at GASO BDT may include different age groups participating together. By knowing all these risks, I hereby assume all these risks and hereby release and discharge GASO BDT LLC from any and all liability resulting from the athlete's participation in any aspect of GASO BDT. I understand it is my responsibility to inform the GASO BDT staff of any medical conditions or any other special needs the athlete might have and will notify the appropriate individuals of any health issues that might in any way affect the athlete's active or passive participation in GASO BDT. I hereby assume all responsibility for any and all costs associated with the treatment of the athlete for any injury or health issue that arises during the participation of GASO BDT. If you agree to these terms please sign below. *
I hereby give permission to GASO BDT to use my child's photo/video of them participating in advertising material and on Social Media.
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