QRD Medical Information Form - U14 (Quinte Red Devils)

QRD Medical Information Form - U14

Player / Parent Information

Medical Information and History

Additional Medical Information

Please provide any additional information / details that may be important but not covered above.

1. I understand that it is my responsibility to keep the team Trainer advised of any changes in the above information as soon as possible. In the event of a medical emergency and that no one can be contacted, team management will arrange to take my child to a hospital or physician if deemed necessary.
2. I hereby authorize the hospital staff to undertake examinations, investigations, and necessary treatments for my child.
3. I also authorize release of information to appropriate people (coach, physician) as deemed necessary.
By submitting this form, I am agreeing to these terms and conditions.