Informed Consent and Acknowledgement

I hereby give approval for the above named child to be transported by {My Dear Transportation Services, LLC.}  I assume all risk and hazards incidental to the transport to and from the requested pick-up and drop-off locations, and release, absolve and hold harmless {My Dear Transportation Services, LLC.}. and all its respective officers, agents, and representatives, drivers from any and all liability for injuries to said child arising out of traveling to and/or from, participating in, or returning from the requested pick-up address and/or drop-off address.

In case of injury to said child, I hereby waive all claims against  {My Dear Transportation Services, LLC.}. including all drivers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises, vehicles used to conduct the transportation. 

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the My Dear Transportation Services, LLC. and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.