Medical Release
I/we hereby authorize CT Blue Jays Baseball and its coaches/staff to act in my/our behalf in obtaining emergency medical treatment for my/our son if I/we am/are unable to do so my/ourselves.
Players Name *
Your answer
Mother’s Name *
Your answer
Mother’s Cell Phone *
Your answer
Mother’s Work Phone *
Your answer
Fathers Name *
Your answer
Fathers Cell Phone *
Your answer
Fathers Work Phone *
Your answer
Medical Insurance Company *
Your answer
Medical Insurance Number *
Your answer
Doctor *
Your answer
Doctor *
Your answer
Parent or Guardian electronic signature *
By printing your name below you are signing this documnet
Your answer
Waiver *
I/We, the parent(s)/guardian of the above named candidate, give my/our approval to participate in the Connecticut Blue Jays Program. I/We assume all risks and hazards incidental to such participation including transportation; and I/We do hereby waive, release, absolve, indemnify, and agree to hold harmless the Organizers, Coaches, Sponsors, and Adult Supervisors, for any claim arising out of an injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance
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