Medical Release (PDF)

Event Medical Release Form
Event Participating*
Event for Export
Participant's Name*

First NameLast Name
Participant's School*
Year of H.S. Graduation *
Best Email to Contact
example@example.com
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.
Cross Training Athletics has my permission to use any photos or video taken of me during camp for instructional purposes and/or publicize future events:*
Cross Training Athletics (CTA) does not provide medical insurance for participants of any of their events or functions. In the event of illness or injury requiring treatment or hospitalization, family medical insurance must be used. Parents will be billed directly for any medical care given at the local hospital. I understand that I may sustain an injury to the extent of broken bones, sprains, strained, chipped or lost teeth, paralysis, or even death. In understanding this, I do hereby release Cross Training Athletics and their respective employees, members and volunteers from any liability in the event of accident, injury or death. The above information has been explained by the CTA Staff and I and my parent/ guardian understand that I am participating at my own risk. CTA does not insure any injury that may occur during the event on or off the field. Lastly, I understand that Cross Training Athletics is a Faith-based, Non-profit organization that will share Biblical truth. By signing in the area below, I am stating that I am in agreement with these terms. (Please use your mouse to make your signature.)
Participant's Signature
Name*

First NameLast Name
Signature*

Clear
Parent or Guardian Signature

REQUIRED IF PARTICIPANT IS 17 YEARS OLD OR YOUNGER
Parent Name

First NameLast Name
Parent Signature

Clear
Should be Empty:

Event Medical Release Form

Participant's Signature

Parent or Guardian Signature