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CENTRE COLLEGE ATHLETICS MEDICAL WAIVER

Please attach a copy of your most recent sports physical and insurance card 
Emergency Contact
If above parent/guardian cannot be reached, please contact:
Please list any allergies, injuries or conditions that could impact your ability to participate in this event/camp.
Release and Waiver of liability: please read and sign.

On behalf of                                         I hereby release, waive, discharge, and agree not to hold Centre College and its staff responsible for any and all liability including any and all claims, demands, causes of action, suits or judgement of any and every kind arising from any injury, damage, or death that they may suffer as a result of participation in this event.

 

Parent/guardian signature (if under 18):

 

 

 

Date

Upload Sports Physical/Insurance Card

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