Please read, understand, and sign the following release, indemnity, and authorization for treatment.
I consent to the aforementioned player(s) participating in any Winchester Basketball Association (WBA) programs or activities. I acknowledge that participation in clinic activities has inherent risk. I, the undersigned parent or guardian, assume that risk on behalf of my child(ren) and will indemnify and hold harmless the WBA from and against all claims and demands on account of, or in any way from, any accidental occurrence. In the event that my child(ren) should need further medical treatment while at the clinic, I give the clinic medical staff permission to order x-rays, routine tests, treatments that may require hospitalization, and necessary transportation. I give the clinic medical staff permission to administer medication or treatment prescribed by the clinic's local physician should this become necessary. I understand that the clinic medical staff may be unable to contact me at the time when medical treatment is necessary and therefore grant permission for them to seek and administer such treatment and medication prior to contacting me for further permission. I authorize payment of medical benefits to the health care provider for any necessary services and the release of any medical or other information necessary to process claims for visits incurred. In addition, I give the clinic medical staff permission to administer other over-the-counter medications they deem necessary. I confirm that, to the best of my knowledge, my child is not allergic to any medications other than those previously disclosed. I have read the above and understand its meaning.