Forms

Please enter your information and submit below! Make sure to both fill out your information, and sign for the safety information and contracts.

Already submitted your information, but need to sign the Info Receipt and Release forms? Click here!

Info receipt and release form

Parents and players, we need two electronic forms completed and signed: the Medical Consent/Info Form, and the Receipt of Info and Release Form, both on this page. It will take 10-15 minutes to review, complete, sign, and submit these forms. Thanks for taking the time to submit and review this critical info!

Medical Treatment Consent and Info Form

* Indicates required field

Grade *

School *

Choose One *

Male Female

Player First and Last Name *

First

Last

Player Email *

Player Phone *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Allergies: *

Medications currently using: *

Medical History (Major illness, hospitalization, surgeries): *

Parent or Guardian: *

Other Parent or Guardian *

Cell Number *

Email *

Emergency Contact *

Relation to player *

Phone Number *

Health Insurance Company *

Group Plan Number *

Policy Number *

Family Doctor *

Doctor Phone Number *

BY MY ELECTRONIC SIGNATURE BELOW, I HEREBY GIVE PERMISSION, IN THE EVENT OF AN ACCIDENT, INJURY, OR ILLNESS, FOR ANY AND ALL NECESSARY MEDICAL CARE TO BE ADMINISTERED TO MY CHILD. SHOULD A COACH, CHAPERONE, OR ANYONE OVER THE AGE OF 18 YEARS OF AGE DEEM IT NECESSARY FOR MY CHILD TO BE MEDICALLY TREATED AND OR TAKE TO A HOSPITAL, I HEREBY GIVE MY PERMISSION FOR MY CHILD TO BE TAKEN TO THE NEAREST HOSPITAL. THIS RELEASE IS EFFECTIVE FOR THE TIME DURING WHICH MY CHILD IS PARTICIPATING IN ANY ULTIMATE EVENTS INCLUDING BUT NOT LIMITED TO PRACTICES, CONDITIONING, TOURNAMENTS, LEAGUE GAMES, SCRIMMAGES, OR TEAM ACTIVITIES. I ALSO HEREBY ASSUME RESPONSIBILITY FOR ANY BILLS RESULTING FROM SUCH TREATMENT. THIS CONSENT FORM IS VALID DURING THE 2019-2020 SCHOOL YEAR. PLEASE SIGN IN THE SPACE BELOW: *

Parent/Guardian Signature *

Submit