CT Swish Basketball Camp - Farmington

Parent/Guardian Information

Link to Blank Required Form:

Youth Camp Health Record

or

Health Assessment Form

Link to Blank Optional Forms:

Authorization for Administration of Medication

Individualized Care Plan

Immunization Exemption

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Connecticut Swish Basketball Camp during the selected camp. In exchange for the acceptance of said child’s candidacy by Connecticut Swish Basketball Camp, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Connecticut Swish Basketball Camp and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Connecticut Swish Basketball Camp including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

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 also granted to the Connecticut Swish Basketball Camp and its affiliates including Directors, Coaches, and Camp Trainers 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 camp 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.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.