NAME OF ALL PARTIES AUTHORIZED TO PICK UP PARTICIPATES AND PHONE NUMBER
DOES PARTICIPATE HAVE MEDICAL INSURANCE? Yes No
IF YES, WHAT IS NAME OF PROVIDER AND POLICY OR CERTIFICATE NUMBER
DOES PARTICIPATE HAVE ANY HEALTH OR PHYSICAL ISSUES WE NEED TO BE AWARE OF? Yes
IF YES, PLEASE FULLY EXPLAIN
My child has had a recent physical examination and is able to participate in league
play. I hereby release the Franklin Youth Tennis Association and volunteers from
all liability from injury or illness incurred while participating in league play.
I hereby authorize volunteers and officials from the Franklin Youth Tennis Association
to act on my behalf according to their best judgement in any emergency situation.