Parental Consent:
I agree to hold harmless the physicians, hospital, and other persons; including but not limited to The Salvation Army Oak Creek Centennial Corps Community Center (SAOC), staff and volunteers, who act upon consent for emergency medical care and/or treatment.
I approve this application and certify that the applicant is capable of such an experience. No refunds will be given unless the league is canceled, and I understand that no refunds will be given if the child leaves because of an illness or injury.
By signing this form, I certify approval of good health of the child and in the event that I cannot be reached in an emergency, I authorize the SAOC staff, and/or volunteers to render first aid.
I understand that by signing this form, I agree to release the SAOC from any liability for the risk of illness, accidents, or injury.
I give permission for the SAOC to hospitalize, secure proper treatment for and to order injections, anesthesia, or surgery for my child as named. (Attempts will be made to contact parent and/or guardian immediately.)
Permission is also given to use any video or photographs that my child may be in for future SAOC use. I agree to waive any claims against the SAOC and its members, officers, employees and volunteers to injuries or damages that may result from the conduct of other persons, including participants in The SAOC league. By signing below, I agree to all consents written above.
Date: _______________________________
Parent / Guardian Signature:______________________________________________________________
Dodgeball registrations are due by March 16th, 2016
Thank you!
TJ Anguiano
8853 S. Howell Avenue
Oak Creek, WI 53154
(414) 762-3993