Medical Consent AWS

PLAYERS NAME PLAYERS DATE OF BIRTH AS THE PARENT OR LEGAL GtJ AR.DIAN OF THE ABOVE NAMED PLAYER., I HEREBY GIVE MY CONSENT FOR-EMERGENCY MEDICAL CARE. PRESCRJB ED BY A DULY LlCENSEDDOcTOR.OFMEDICINE OR DOCTOR OF DENTISTRY. THIS CARE MAYBE GlVEN UNDER WHATEVER CONDITIONS ARE NECESSARY TO PRESERVE THE LIFE, LIMB OR. WELL-BEING arMY DEPENDENT. SIGNATURE

OF P AR.ENT!Ql.1ARDIAN

DATE ALLERGIES TO MEDICATION DOCTOR IN SURA NCE£OMP

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PLAYERSDATE OF BIRTH AS THE PARENT ORLEGAL GUARDIAN OF THE ABOVE NAMED PLAYER., I HEREBY GIVE MY CONSENT FOR EMERGENCY MEDICAL CARE PRESCRIBED BY A DULY LICENSED DOCTOR OF MEDICINE OR DOCTOR OF DENTISTRY. THIS CARE MAY BE GIVEN UNDER WHATEVER CONDITIONS ARE NECESSARY TO PRESERVE THEtIFE, LIMB OR WELL-BEING OF MYDEPENDENT. SIGNATURE OF PARENT/GUARDIAN

DATE ALLERGIES TO MEDICATION

DOCTOR INSURANCECOMPANY

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PLAYERS NAME PLAYER-SOATE OF BIRTH AS THE PARENT OR:LEGAL GOARDIANOF THEABQVENAMEDPLAYER., I HEREBY GIVEMY CONSENT fOR EMERGENCY MEDICA LCARE PRESCRIBED BY A DULY LICENSED DOCTOR OF MEDICINE OR DOCTOR OF DBNTISTRY. THIS CARE MAYBE GIVEN UNDER WHATEVER CONDITIONS ARE NECESSARY TO PRESERVE THEUfE, LIMB OR WELL-BEING Of MY DEPENDENT.

SIGNATUREOfPARENT/GUARJ)lAN DATE ALLERGIESTO MEDICATION DOCTOR INSURANCECOMPANY

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FLA YERSNAME PLA YERSDATEOf

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BIRTH

AS THE PARENT OR LEGAL GUARDIAN Of THEABQVENAMEDPLAYER, I HEItEB¥GlVE MY CONSENT FOR EMERGENCY MEDICAL CAREPRESCRJBED BY A DULY LICENSED DOCTOR OF MEDICINE OR DOCTaROF DENTISTRY. TIjI$ CARE MAYBEGIVEN UNDER. \\lHA TEVER. CONDITIONS ARE NECESSARY TO PRB.$E.RVETHE UFE, LIMB OR WELL~BEING afMY DEPENDBNT.

SIGNATUREOF PARENT/GUARDIAN DATE ALLERGIES TO MEDICATION

DOCTOR INSURANCECOMPANY