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Parents/legal guardian

Do you have a doctor's permit to participate in intense physical activities?

Player's informations

Waiver of Claims and Release of Liability

Player's informations

The undersigned, being a parent or legal guardian of the player, does hereby affirm that the player is in good health and free from any illness, disability or condition requiring regular medication other than those which have been disclosed and approved.

The undersigned hereby grants permission to The Art of Game for use of pictures, images and video taken at camps, clinics, practices games and workouts which may be used for promotional purposes. Outside video and still photography will not be allowed in the gym during private sessions or clinics. It is also requested that cell phones be put into silent mode during coaching sessions.

In the event of accident or injury requiring immediate emergency treatment by professional medical personnel, the undersigned hereby gives consent to The Art of Game staff to procure any medical treatment deemed advisable on behalf of the player.

The undersigned understands the benefit of getting a physical prior to intense physical activity and that they will be removed from action at the first signs of any head injury or concussion. Parents agree to educate their entire family with concussion-awareness material, such as the free “Head’s Up: Concussion in Youth Sports” program and by signing below acknowledge their support, com- prehension, understanding and awareness. Players will be required to visit a licensed health care professional for an evaluation and clearance prior being allowed to return to participation and must present a signed statement to prove doctor’s approval.

The undersigned warrants that the player is fit to participate in rigorous physical activity and expressly represents the undersigned as the financially responsible party with regard to any and all medical costs, charges or fees incurred or resulting from the treatment of any and all illness or accident while under direct supervision of The Art of Game staff.

The undersigned hereby releases The Art of Game, Milan Smiljanic, all facilities, all coaches and all staff members from any and all financial and legal liability associated with and/or arising from injuries or illness suffered by the player during participation in or with The Art of Game.

The undersigned acknowledges that he/she has read and understands this liability waiver/emergency contact form and agrees to waive any rights, express or implied, under Pennsylvania State Law to recover any and all medical expenses from The Art of Game through court action, arbitration and/or any other legal means.

*All participants under age of 18 years old must have a parent or guardian signature.

Player's informations

Player's informations

Parents/legal guardian

Do you have a doctor's permit to participate in intense physical activity?
Yes
No
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