U10A - Medical Form, U10A - Gordon Ruth & Co, A Teams (South Oxford Minor Hockey)

I understand that it is my responsibility to keep the team Safety Person advised of any change 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 the hospital or a physician if deemed necessary. I hereby authorize the
physician and nursing staff to undertake examination, investigation and necessary treatment of my child. I also authorize release of information to appropriate people (coach, physician) as deemed necessary.

By accepting this acknowledgement digitally, you are providing your signature of agreement.

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