AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT
By submitting this form you give your consent for your child's participation in any and all Team Virginia Athletics Mizuno functions or activities. In the event of any injury or sickness occurring during any Team Virginia Athletics Mizuno functions or activities, you authorize any official(s) to administer first aid and if necessary to transport your child to the nearest emergency treatment facility.
You release Team Virginia Athletics Mizuno and any person(s) connected with Team Virginia Athletics Mizuno Organization of any responsibility from accident or injury incurred as a result of her participation in any and all activities, including transportation to and from any Team Virginia Athletics Mizuno functions or activities.
You certify that you child has been given a physical examination and is physically able to participate in all related activities. Please notify in writing any prescribed medications and / or physical conditions of which the Team Virginia Athletics Mizuno coaching staff or assistants should be aware of are listed below.
You also acknowledge and agree that all related medical costs are your responsibility.