Request Membership in this Organization!
* indicates a required answer.
In the event of an emergency occurring involving my son/daughter while at a Cornerstone Family School sponsored activity, I grant permission to the coaches to take whatever action necessary to ensure my son/daughter receives proper medial attention.
Person to be notified, other than parent or guardian, in an emergency:
Please list any medical conditions that we need to be aware of:
Please list any medications that your child is currently taking and any known allergies:
By entering your name, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this form.
I certify that my child, named above, is physically capable and able to fulfill requirements needed to participate in the above named sport. By signing this form, I release all obligations for the medical treatment of my son/daughter in the event of illness or injury during any sport related activity when either parent cannot be reached. If there is any physical or medical reason why he/she should not participate fully, Cornerstone Family School requires a doctor's release. Furthermore, Cornerstone Family School is not liable for any injury incurred during the sport season.