MEDICAL RELEASE AND AUTHORIZATION
I, stated above, residing in city and state stated above, authorize the following persons to receive information pertaining to my child's medical condition, health information, medications, and other health-related information:
Prestwick Tennis Club’s Academy Director and/or Owners and Operators or any other person that Prestwick Tennis Club reasonably determines should have access to my child's health information
I also authorize Prestwick Tennis Club to obtain such professional medical/surgical care or hospital services as may appear to be necessary or desirable for the protection of the health or life of my child. I authorize Prestwick Tennis Club to administer emergency care or treatment as required, until emergency medical assistance arrives.
I authorize Prestwick Tennis Club to provide to any healthcare provider with my child's medical/health information. Any person rendering health care pursuant to this authorization shall be entitled to treat this consent as having been given by me to such person. I further agree to pay and to hold Prestwick Tennis Club harmless for any reasonable medical, dental, hospital, or other related charges incurred on behalf of my child.
This Authorization and Consent remains in effect from the date of my child's enrollment through the duration of the season or withdrawal and/or separation from the academy, unless otherwise notified in writing.
General Release of Liability and Assumption of Risk In consideration of my use of the tennis facility and any other facilities operated by Prestwick Tennis Club, on behalf of myself and my next of kin, heirs, executors, and administrators.
I hereby release, waive, discharge, and covenant not to sue Prestwick Tennis Club, and its coaches, officers, trustees, directors, volunteers, agents, and employees (collectively Prestwick) from any and all claims, demands, damages, actions, liabilities, causes of action, or suits in equity of whatever kind or nature, including, without limitation, claims of Prestwick's negligence, resulting from any physical or psychological injury (including paralysis and death), illness, damages, or economic or emotional loss I may suffer arising from or relating to my use of tennis club, including travel to, from, and during my use of the tennis club.
I am voluntarily participating in activities on Club Property. I am aware of the risks associated with diving, swimming, dry-land training, team building, and social activities that may relate to or arise from my use of School Property. These risks include but are not limited to physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and/or death. I understand that these injuries or outcomes may arise from my own or others actions, inaction, or negligence; conditions related to travel; or the condition of the Program location(s). Nonetheless, I assume all related risks, both known and unknown to me, of my use of School Property, including travel to, from, and during my use of Property.
I agree to indemnify and hold harmless Prestwick Tennis Club from any and all claims, loss, liability, judgment, settlement, damage, or costs, including expenses and attorneys fees for both the trial and appellate levels that may occur as a result of my participation in any pool activity or any other activities incidental to my use of Club Property, wherever, whenever, or however the same may occur.
I hereby give consent for any medical treatment or emergency medical services that may be needed in connection with my use of Prestwick Tennis Club facility.
I agree to assume all costs related to such treatment, including transportation costs. I further authorize the release of any medical information necessary to process a claim for accident/medical payment insurance for an injury or illness relating to my use of Club Property.
I understand that this document will be construed in accordance with the laws of the State of South Carolina. Any legal action or proceeding relating to my use of Club Property will be brought exclusively in the state or federal court located in Myrtle Beach, South Carolina and I consent to the jurisdiction thereof. If any portion of this document is held by any court of competent jurisdiction to be illegal, null, void, or against public policy, the remaining portions shall not be affected and I will continue to be bound by the remaining terms.
I have read this document in its entirety and understand all of the terms and conditions it contains. I accept and approve of this document freely. No oral representations, statements, or inducements apart from this general release of liability and assumption of risk form have been made. I execute this document for full, adequate, and complete consideration fully intending to be bound by the same, now and in the future.