Medical Release & Appearance Form
PLEASE PRINT CLEARLY
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Participant Name
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Participant’s Grade
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School Name _______________________________ Cheer Coach Name ______________________________
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Parent or Legal Guardian
I, the undersigned parent or legal guardian, do hereby grant permission for my son/daughter to participate in the 2008
Spiritfest tournament. I further acknowledge and understand and agree that by participating in this tournament there
is a possibility of physical illness or injury (minimal, serious, and catastrophic) and that my son/daughter is assuming
the risk of such injury by participating. I authorize any representative of Oak Harbor High School or the event party to
consent and authorize any medical attention, treatment, surgery or administration of drugs by qualified and licensed
medical personnel for my son/daughter, which may become necessary. I understand I will be notified as soon as
possible in the event of an emergency. I understand and agree that all expenses of such treatment are my responsibility.
I agree to protect, defend, indemnify and hold harmless Oak Harbor High School, including its staff, employees and
sponsors from and against any and all claims, demand, losses, suits, liabilities, costs, or other damages including court
costs and attorneys fees, arising from any injury to, or death of son/daughter, the undersigned, or any other persons
or damage to or destruction of property arising out of or in connection with any damage to third parties occasioned
by, incident to, arising out of, or in connection with my son/daughter's participation. I understand that Oak Harbor
High School produce’s promotional material about the program. I understand that my son/daughter may be included
in videotape or photography taken during this event. I hereby grant Oak Harbor High School, its successors, assignees,
licensees, sponsors, any television networks and all other commercial exhibitors the exclusive right to photograph and/or
videotape my son/daughter and further to utilize my son/daughter's name, face, likeness, voice and appearance as part of
the event, and in advertising and promotion of the event, without reservation or limitation. In granting this license, I
understand that Oak Harbor High School is under no obligation to exercise any of its rights, licenses and privileges
herein granted.
Rules/Regulations
• No smoking, consumption of alcoholic beverages or use of illegal drugs allowed.
• Oak Harbor High School reserve the right to discipline any participant for unruly behavior or for conduct unbecoming
to the event.
• Participants must respect all venue, campus and facility rules and regulations.
• Participants must obey all rules and regulations set forth by the event.
I have completely read and understand the above release and rules/regulations.
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Signature of Participant:
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Signature of Parent or Guardian: Signature of Participant:
Street Address: ___________________________________________________________________________
City: _____________________________ State: _______________ Zip Code: _________________________
Home Phone: _______________________________Business Phone:________________________________
E-mail Address: __________________________________________________________________________
Medical Insurance Company/Policy: __________________________________________________________
Emergency Contact: _______________________________________________________________________
Phone Number: ___________________________________________________________________________