CNSC PARENT INFORMATION, CONSENT AND RELEASE FORM

Cross-country skiing is a safe and healthful activity, but there are certain inherent risks present when your child participates in the program. We strongly recommend you have medical insurance for every skier. Craftsbury Nordic Ski Club does not carry medical insurance.

RELEASE AND INDEMNIFICATION:
In consideration of the offer of the Craftsbury Nordic Ski Club (CNSC) a non-profit organization, to provide supervised skiing, skiing instruction, off-season training and competitive skiing opportunities, I do hereby agree to indemnify and hold harmless CNSC, its members, supervisors, instructors, agents and representatives, including the Craftsbury Outdoor Center, whether paid or unpaid by CNSC, from any and all liability whatsoever for any loss, injury or death to myself or my child or by any third party as a result of my own or my child’s participation whether during instruction, practice training, competition, or while otherwise engaged in ski activities under the direction and supervision of CNSC.

As the parent of __________________________________, I have read and understand the above statement.                    Child’s Name

Signature of Parent or Adult Participant ______________________________  date___________

MEDICAL CONSENT
In the event of a health emergency or injury to my child during participating in the program, I consent to emergency medical transportation and treatment on his/her behalf and release CNSC and affiliated persons from all resulting liability.

Child’s Doctor_____________________________ phone______________________

_________________________________ ________________
Signature                                                   Date

MEDICAL CONDITIONS
My child has the following medical condition or disability:_____________________________
_____________________________________________________________________________
(Please indicate conditions such as allergies, heart and lung problems, diabetes, and epilepsy, or other conditions that might affect your child’s safety.)

My child takes the following medications(s):________________________________________________

Emergency phone  number/contact__________________/_____________________________________________

Parents’ Names _____________________________________________________________