I/we being the legal guardians of the applicant authorize the staff of this clinic and its agents permission to request treatment to ensure the well being of our dependent. I certify that he is in good health and able to participate in the scheduled games.

In consideration of participating in this tryout, practice, game, skill session and or clinic, the player named above and the parent or guardian do hereby agree for ourselves, our heirs, executors and administrators, to release, hold harmless and forever discharge the hosting organization and their officers, staff, administrators, volunteers, sponsors and representatives and assigns, for and against any and all claims, actions, cause of actions, suits, judgments, and demands whatsoever directly or indirectly in connection the player’s participation in the event.