MEDICAL TREATMENT WAIVER
I declare I am the parent or legal guardian of the registrant, a minor, and have full custody and control of the child. To the best of my knowledge my child is in good health and is adequately immunized to participate in Club activities. In the event my child is injured or requires medical attention, I hereby request you contact our doctor given above. In the event our doctor cannot be reached I hereby authorize the athletic supervisor, coach or any other GSBA volunteer or employee to secure necessary medical treatment for my child. I further acknowledge I am responsible for any medical or hospital fees or costs associated with my child’s medical treatment. If possible, confirmation of this authorization should be made with me prior to treatment by calling me at the above listed phone. In case I cannot be reached for any emergency, medical treatment may proceed without further authorization.

CONCUSSION POLICY
I have read and understand the information provided on the Grizzlies Select Basketball Association Concussion Form regarding concussions. Signature not required, but must click the acknowledgement box below to complete registration.


BY CHECKING THE BOX BELOW I ACKNOWLEDGE I HAVE READ, UNDERSTAND AND AGREE TO ALL ITEMS ABOVE.