CRFC Medical Treatment Authorization and Consent for Minor
This form is necessary for those situations where minors are unaccompanied by either parents or legal guardians. This “Medical Treatment Authorization and Consent Form” gives authority to a designated adult to arrange for medical care for a minor in the event of an emergency. This is extremely important, in that, medical care cannot be provided to a minor without approval by the parents or legal guardians, unless there is written consent authorizing an agent to give approval.
Please enter information for the player. This form is only required for players under age 18.
Minor's Full Name
Minor's Primary Home Address
Minor's Birth Date
Page 1 of 3
Never submit passwords through Google Forms.
This form was created inside of Chillicothe Rugby Football Club.
Terms of Service