2008/09 BRANDYWINE VOLLEYBALL CLUB PERMISSION TO PARTICIPATE
DOES THIS PARTICIPANT HAVE ANY MEDICAL PROBLEMS PRESENTLY OR IN HER HISTORY THAT WILL OR COULD INTERFERE WITH HER ABILITY TO PERFORM PHYSICALLY CHALLENGING TASKS OR WILL OR COULD BE AGGRAVATED AND/OR WORSENED BY SUCH ACTIVITY ?

IF THE ANSWER IS YES PLEASE EXPLAIN.
IS THE PARTICIPANT CURRENTLY TAKING ANY MEDICATIONS ? IF YES,

PLEASE LIST MEDICATION AND WHY
PERMISSION TO PARTICIPATE

AS THE LEGAL GUARDIAN OF THIS PARTICIPANT, MY SIGNATURE ON THESE DOCUMENTS VERIFIES THAT ALL OF THE INFORMATION ON THIS SHEET IS TRUE. I ALSO RECOGNIZE THIS ACTIVITY COULD BE PHYSICALLY CHALLENGING AND THAT MY DAUGHTER COULD SUSTAIN AN INJURY OR INJURIES WHILE PARTICIPATING. I FURTHER VERIFY THAT MY DAUGHTER DOES NOT HAVE ANY MEDICAL CONDITIONS WHICH COULD BECOME LIFE THREATENING SHOULD SHE PARTICIPATE IN ANY OF THE ACTIVITIES ASSOCIATED WITH THIS VOLLEYBALL PROGRAM. IN ADDITION, MY SIGNATURE ALSO INDICATES I AGREE NOT TO HOLD THE BRANDYWINE VOLLEYBALL CLUB OR ANY OF IT’S COACHES LIABLE IN ANY WAY SHOULD MY DAUGHTER SUSTAIN AN INJURY WHILE PARTICIPATING IN OR TRAVELING TO ANY VOLLEYBALL TOURNAMENT, SCRIMMAGE OR PRACTICE; REGARDLESS OF THE SEVERITY OF THE INJURY.

MY DAUGHTER AND I ALSO UNDERSTAND THAT IF SHE ACCEPTS A POSITION ON ONE OF THE BRANDYWINE VOLLEYBALL CLUB TEAMS, SHE IS EXPECTED TO MAKE A FIRM COMMITMENT TO THIS PROGRAM AND A SINCERE EFFORT TO ATTEND ALL THE SCHEDULED PRACTICES AND TOURNAMENTS. IF POOR ATTENDANCE AT PRACTICES OR TOURNAMENTS BECOMES AND ISSUE I UNDERSTAND THAT MY DAUGHTER MAY BE ASKED TO RESIGN HER POSITION AS A MEMBER OF THE TEAM AND THAT NO MONIES WILL BE REFUNDED TO ME.

I GRANT MY PERMISSION FOR MY DAUGHTER TO PARTICIPATE IN THE ACTIVITIES SPONSORED BY THIS PROGRAM AND I UNDERSTAND THE EXPECTATIONS OF THIS PROGRAM AND I AGREE TO THE ABOVE MENTIONED TERMS.
GUARDIAN’S SIGNATURE______________________________________    DATE_______

PARTICIPANT’S SIGNATURE___________________________________    DATE_______