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CONCUSSION IN YOUTH SPORTS
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2025 Fall Individual Player - Player without Current Team
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Birthdate:
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Age as of August 31, 2025:
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Last Name:
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First Name:
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Email Address:
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Street Address:
City:
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Zip Code:
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Phone:
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Emergency Contact Name & #:
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Prior Park & Team:
WAIVER INFORMATION: I hereby authorize the staff of the clinic to act for me, according to their best judgment, in any emergency requiring medical attention, and herby waive and release the clinic from any and all liability for any injuries or illnesses incurred while at the clinic. I have no knowledge of any medical problem or physical impairment that would be affected by the above names camper's participation in the clinic.
It is further understood that Bryant Softball Association, City of Bryant, Bryant High School, or any staff of this clinic does not provide medical insurance covering injuries of any nature incurred at this clinic. The undersigned hereby releases Bryant Softball Association, City of Bryant or Bryant High School, it's successors, assigns, officers, agents, and employees, from any and all claims, demands, and causes of action whatsoever in any way growing out of resulting from participation of the forenamed child in the softball clinic. We (clinic staff) reserve the right to excuse a camper if needed for any disciplinary reason.
I/we agree with the above
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* indicates required fields