Superstars Gymnastics Camp

Medical Release Form

 

 

Name of child _________________________________________Birthdate___________

 

Parents name(s)                                                                      Phone #

__________________________________________            ________________________

__________________________________________            ________________________ 

 

 

 

Ok to provide Motrin, Tylenol?   yes  ____   no _____

 

 

 

I hereby authorize the directors of Superstars Gymnastics Camp, LLC to act for me according to their best judgment in any case of emergency requiring medical release, exonerate and discharge the camp and its employees and contractors and Desert Lights Gymnastics from any and all actions or cause of actions, known or unknown, for any injuries incurred while at camp, or on the way to, or from camp.

 

_____________________________________________

Name of Parent or Guardian (Please Print)

 

 

_____________________________________________                 ______________

Parent or Guardian Signature                                                            Date