(for girls in 5th to 8th grade) we will have a unique opportunity to tour the mother house in mishawka, talk, play and pray with the sisters and visit with sr. mary grace who made her first profession on august 10, 2011. bring a few dollars for...
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Liability waiver dear participant/ parent: you/your child have an opportunity to participate in a pathfinder program. to be eligible, you must sign this release form. the program is customized to meet the learning goals of your group. for general...
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2014 medical information & waiver form the coastwise packet co. d.b.a. the black dog tall ships p.o. box 429, vineyard haven, ma 02568 tel: (508) 6931699 fax: (508) 6931881 as a reminder: we require that this form is completed and returned at...
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Camp attending: date of camp: 2016 summer camp medical information and waiver steps for parents/guardians: 1. fill out pages 1 and 2 of this form. you must sign and date page 2. it is your responsibility to complete this form. any missing...
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Consent, waiver, insurance and medical informationray harper basketball camp, llc (ray harper basketball camps 2014)if any illness, injury, or other condition or occurrences arise which, in the solejudgment of the ray harper basketball camp, llc...
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Marine & environmental science summer camp 2015 forms due to khunsucker fit.edu / dmes office no later than june 15, 2015 camper information, waiver & release forms 1. medical information: does the camper have any special dietary needs? yes no (if...
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Consent, waiver, insurance and medical information east coast field hockey in partnership with medical: known medical conditions: primary medical insurance carrier policy number if any illness, injury, or other condition or occurrence arises...
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Isu medical information form and release and waiver of liability note: the release and waiver of liability must be signed by the participant's legal guardian if the participant is not of legal age. participant information participant's name...
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Acadia university open house friday october 19th, 2012 bus transportation permission slip: student name: grade: address: home phone #: date of trip: pickup location: friday october 19, 2012 dartmouth sportsplex (7:30am) and bedford place mall...
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Medical information & waiver forms this packet contains medical information forms and a sample waiver and release from liability form. in today's climate of insurance claims and liability action, the use of these forms is mandatory by your club...
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City of saco, maine telephone: (207) 2833139 fax: (207) 2828210 email: parksandrec sacomaine.org parks & recreation department 300 main street saco, me 040721538 medical information & waiver childs name: program: name of medicine: prescribing...
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Usa wrestling parent's instructions on medical treatment please print in capital letters wrestler's name date of birth parent/guardian name relationship address work phone home phone please indicate another person to call it an accident occurs and...
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Medical information/hospitalizationforma refund or waiver of certain fees or charges may be granted in documented cases of hospitalization. please notethat a refund or waiver is not guaranteed, and you must be the hospitalized party, traveling...
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Medical information form and release note: the release must be signed by the participants parent/legal guardian if the participant is not of legal age. as the parent/legal guardian of , i request that in my absence the abovenamed minor be admitted...
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City of saco, maine parks & recreation department 300 main street saco, me 040721538 medical information & telephone: (207) 2833139 fax: (207) 2828210 email: parksandrec sacomaine.org w a i v e r p o l i c y (18march13) participants with medical...
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