St Lucy Catholic Parish School
A Siena Catholic School

 

Parent Risk Acknowledgement Consent Form

Form
6145.2(b)

ARCHDIOCESE OF MILWAUKEE

Parent’s and/or Legal Guardians
Risk Acknowledgement and Consent to Participate Form

during the school year: 2019

I/We will realize that there are numerous risks involved in participating in the above listed sport(s). These risks could involve (but are not limited to): sprains, contusions, broken bones, lacerations, concussions, permanent disability, internal injuries, paralysis, and possibly death. These risks could impair my/our child’s future abilities to earn a living, engage in business, social, and recreational activities and to generally enjoy life. I/We have been informed about the various risks associated our child’s participation in the above listed sports and the potential injuries that may occur.

I/We will assume all responsibility and certify my/our child is in good physical condition and has undergone a sports physical in the past two years. Further, I/we are unaware of any medical condition that would inhibit my/our child’s participation.

As a condition of our child’s voluntary participation in the above mentioned sports, I/we agree to accept all the previously mentioned risks as a condition of my/our child’s participation.

By entering my full name, I attest that this constitutes my legal electronic signature of this form.


Form 6145.2(b) Form