By entering PayPal Buy Now button (below), you acknowledge and agree to the following:
As a Parent and as an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By entering PayPal Buy Now button, you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury.
I have read the Parent Concussion and Head Injury Information (http://www.wiaawi.org/Portals/0/PDF/Health/ConcussionCondensedInfo.pdf) and understand what a concussion is and how it may be caused. I also understand the common signs, symptoms, and behaviors. I agree that my child must be removed from practice/play if a concussion is suspected.
I understand that it is my responsibility to seek medical treatment if a suspected concussion is reported to me.
I understand that my child cannot return to practice/play until providing written clearance from an appropriate health care provider to his/her coach.
I understand the possible consequences of my child returning to practice/play too soon.
I certify that I am the parent or legal guardian for my child(ren). I hereby give my permission for any supervisor, coach, board of directors or other administrator associated with Suburban Athletics to seek and give appropriate medical/athletic training attention, transportation and emergency medical services as warranted for our child(ren) in the event of accident, injury, illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment.
I hereby waive, release and forever discharge Suburban Athletics and associated supervisor, coach, board of directors or other administrator from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in Suburban Athletics activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my children is (are) physically fit and capable of participation in all Suburban Athletics activities.
By registering my child(ren) with Suburban Athletics, I agree to participate (or allow my child(ren) and family members to participate) in Suburban Athletics, and hereby release Suburban Athletics, its directors, officers, agents, coaches, board of directors and employees from liability for any injury that might occur to myself (or to my child(ren) and family members) while participating in the Suburban Athletics program, including travel to and from practices, games or other scheduled team activities.
I agree to indemnify and hold harmless the above mentioned organizations and/or individuals, their agents and/or employees, against any and all liability for personal injury, including injuries resulting in death to me, my child(ren) and/or other family members, or damage to my property, the property to my child(ren) and/or other family members, or both, while I (or my child(ren) or family members) participating in Suburban Athletics program.
We/I give Suburban Athletics, its designees, agents and assigns, unlimited permission to use, publish and re-publish in any form or media, information about me/my child(ren) and reproduction of my/my child(ren)’s likeness (photographic or otherwise) and my/my child(ren)’s voice, with or without identification of me/my child(ren) by name.
We/I agree to give the Suburban Athletics coach emergency contact information for my child(ren).