FAST ATHLETICS
Parent Medical Waiver & Athlete Health Information Packet
For minor participants. Complete all sections before participation.
Complete this form for each athlete under age 18 who will participate in FAST Athletics programs, practices, camps, leagues, travel, conditioning, clinics, or related activities.
Athlete and Parent Information
Athlete Full Name
Date of Birth
-
Month
-
Day
Year
Date
Age:
Gender:
Parent/Guardian Name(s)
Best Phone Number
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Parent/Guardian Acknowledgments
I am the parent or legal guardian of the above-named athlete, and I authorize the athlete to participate in FAST Athletics activities.
I understand that athletic participation involves inherent risks, including but not limited to falls, collisions, overexertion, heat-related illness, equipment-related injury, transportation-related injury, and other serious injury, illness, permanent disability, or death.
To the fullest extent permitted by applicable law, I voluntarily assume these risks on behalf of myself and my child, including risks that may arise from participation, travel, or use of facilities and equipment.
I certify that I have disclosed all known medical conditions, allergies, medications, prior injuries, restrictions, and other relevant health information on the accompanying medical information form, and I agree to notify FAST Athletics promptly of any changes.
To the fullest extent permitted by law, I release and hold harmless FAST Athletics, its owners, directors, officers, employees, coaches, volunteers, facility providers, sponsors, and agents from claims for ordinary negligence arising out of my child's participation, except as prohibited by law or to the extent caused by gross negligence, reckless conduct, or intentional misconduct.
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FORM 2—ATHLETE MEDICAL INFORMATION AND HEALTH HISTORY
Complete this form fully and update it whenever there is a change in the athlete's health status, medications, restrictions, or emergency contacts.
Current Health Information
Does the athlete have any known medical condition or diagnosis that staff should know about? If yes, describe.
Yes
No
Does the athlete have asthma, breathing issues, or use an inhaler?
Yes
No
Does the athlete have severe allergies (food, medication, insect, latex, environmental)?
Yes
No
Does the athlete carry rescue medication such as an inhaler, EpiPen, glucagon, or seizure medication?
Yes
No
Has the athlete ever had chest pain with exercise, fainting, dizziness, or a diagnosed heart condition?
Yes
No
Has the athlete ever had a seizure, neurological condition, or migraine requiring treatment?
Yes
No
Has the athlete had heat illness, sickle cell trait/condition, diabetes, or another condition affecting safe participation?
Yes
No
Is the athlete currently under medical restrictions or awaiting medical clearance?
Yes
No
If you answered "Yes" to any question above, provide details, triggers, warning signs, staff instructions, and activity limits:
Previous Injuries, Surgeries, and Hospitalizations
Please list any previous injuries, surgeries, or hospitalizations:
Concussion and Participation History
Has the athlete ever been diagnosed with a concussion?
Yes
No
Has the athlete had more than one concussion or head injury?
Yes
No
Is the athlete having any current symptoms after a head injury?
Yes
No
Has a healthcare provider ever limited sports participation?
Yes
No
Does the athlete have any current pain, swelling, weakness, or reduced motion during activity?
Yes
No
Explain any "Yes" answers, dates, provider instructions, and return-to-play restrictions:
Parent/Guardian Certification
I certify that the information provided on this form is complete and accurate to the best of my knowledge.
I understand that incomplete or inaccurate health information may increase risk to my child and may affect emergency response and participation decisions.
I agree to notify FAST Athletics immediately if my child's health status, medications, restrictions, physician instructions, or emergency contacts change.
Printed Name:
Parent/Guardian Signature:
Submit
Should be Empty: