SUSPENDED FORM

Parent's/Guardian's Name

Parent's/Guardian's Cell

Parent's/Guardian's Email

Athlete's Name

I, parent/guardian (name indicated above) of said athlete (name indicated above) acknowledge that track and field involves risks that are beyond the control of Cleveland Mustangs Track and Field Club. I acknowledge that the daily workout and occasional competition can be physically strenuous and requires physical fitness and good health of my child/children/self. 
In consideration of the Cleveland Mustangs Track and Field Club accepting my child’s/children’s/self’s participation in practices as well as all transportation or activities in connection with track and field events, I hereby release and forever discharge Cleveland Mustangs Track and Field Club, its Directors, Officers, Agents, Coaches and or successors, heirs and assigns of and from any claim, demand, damage, action or causes of every nature or kind howsoever caused arising out of, attributable to or in any way connected to (or occasioned by) the event, including, without limitation, the negligence of the agents, Directors, and instructors volunteering with Cleveland Mustangs Track and Field Club. 
I agree to inform the staff of the Cleveland Mustangs Track and Field Club of any medical/mental concerns to my child’s/children’s/self’s participation in the event (nondisclosure amounts to a representation that there are no concerns). I agree to ensure that my children/child/self abide/s by the rules and regulations imposed on participants by Cleveland Mustangs Track and Field Club and its staff. These rules and regulations are designed for the safety and protection of all participants. I have read the above and fully understand the terms of this waiver and my subsequent commitment.

Medical Conditions
If medication is required for a med-ical condition indicate in the box en-titled other.

Emergency Contact Name

Emergency Contact Phone

Parent's/Guradian's Signature
Athlete must sign this form if he/she is 18 years of age or older.

Clear

Today's Date

Verification