RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK, MEDICAL TREATMENT AUTHORIZATION AND AGREEMENT TO PAY CLAIMS
Activity: Santa Barbara Running Association Island Foxes Youth Track Club
Activity Location: San Marcos High School
By signing below, I hereby give permission for the above named minor to participate in the SBRA Island Foxes Youth Track Club activities, Junior Grand Prix races and other SBRA events/activities and verify my child is in good health and good physical condition and able to participate in the activity for which I am enrolling them and have not otherwise been advised by qualified medical personnel not to participate in such activities. I, on behalf of my minor and as parent/guardian, assume all responsibility for the above participant while engaged in any SBRA activity and agree not to hold the SBRA responsible for property damage and/or personal injury and/or other loss or damage suffered by myself and/or my minor child during such activities and I further release and discharge the SBRA from any and all causes of action, claims and demands with respect to such damage, injury or loss. I further grant permission to SBRA to any photographs, motion pictures, recordings or any other record of myself or my child during any and all SBRA activities and events.
Parent/Guardian Consent & Emergency Authorization
In an emergency, I hereby authorize each of the Coaches, Volunteers, or other Officials of the Island Foxes Youth Track Club to act as my agents in the capacity of activity supervisors and vehicle drivers, and I authorize each of them to consent to medical, surgical or dental examination and/or treatment for the above named athlete.
I sign this form on behalf of the above named athlete and agree voluntarily and without inducement.
I agree to use an electronic signature and that any physical or electronic copy of this form can be used as if it was an original.