2003 MISSA Team Racing Championship Medical Release.

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MISSA Medical Release/Hold Harmless Agreement


The undersigned parent(s)/guardian(s) understand that an element of risk is involved in all sports, including sailing. Now, therefore, in consideration of participation in this event by the sailor named below, we, the undersigned parent(s)/guardian(s), do hereby covenant and agree to hold harmless and to indemnify the Grosse Pointe Yacht Club, the Midwest Interscholastic Sailing Association, their officers and directors and personnel engaged or volunteering to help conduct this event from any and all liability for any claim, demand, suits or causes of action growing out of or in any wise attributable to any injury or damage to the sailor named below whatsoever, arising out of or in any wise connected with the operation of, participation in, or in any manner connected with this sailing event, or use of Grosse Pointe Yacht Club facilities or equipment.

Additionally, the undersigned parent(s)/guardian(s) gives permission for medical treatment of the sailor named below for illness or accident if they cannot be first contacted.

Event Name:    MISSA 2003 Team Racing Championship

Sailor's Name:    _______________________________________

Parent/Guardian Name:    _______________________________________

Parent/Guardian Signature:    _______________________________________

Date:    _________   Emergency Phone Number:    _________________________________


Accident/Health insurance Policy and Number:_______________________________

_____________________________________________________________________


Please indicate if there is any medical information about the above named sailor of which event organizers should be made aware:

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________


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