Kuna High School

KUNA SNOW SHREDDERS

SKI AND SNOWBOARD RACE TEAM

SKIER/BOARDER’S PERMISSION TO PARTICIPATE;

STANDARD RELEASE OF LIABILITY;

AND

AUTHORIZATION FOR EMERGENCY

MEDICAL TREATMENT

Part A. Permission to Participate

My signature on this form (see reverse side) conveys my permission for my child/legal ward:

______________________________________________, Racer’s Name

to participate as a member of the Kuna Ski and Snowboard Race Team. I understand

members participate in regular and special ski/snowboard races and fun day/practice

events held at Bogus Basin, Brundage Mountain, Sun Valley, and/or Tamarack Resort.

I fully understand that ski and snowboard racing and related activities, contain an element of danger, and in some cases, may result in injury ranging from very minor to severe, or, in rare cases, even death. I assume full responsibility for the condition of the equipment, health and action of my child/ward while participating is the activities listed above, and do, hereby, still voluntarily grant my permission, and thereby authorize my child/ward’s participation in the activities of the Kuna Ski and Snowboard Race Team.

Part B. Release of Liability

I fully understand that my child/ward’s participation, authorized by Part A of this form, is strictly voluntary and, as stated above, that I am solely and completely responsible for my child/ward’s health, actions, and condition of the equipment they use. I understand that my child/ward is expected to conduct him/herself appropriately, follow all ski resort and club team rules of conduct. I understand that helmets are required during all races. I assume all risk and liability associated with my child’s participation in the above described ski/snowboard activities, including any related transportation by bus, van or personal vehicle.Further, my signature on this form signifies that I hereby release the Kuna School District, Judy Payne, and any and all other coaches/advisors/drivers et al, from any and all liability associated with my child/ward’s participation on the Kuna Ski and Snowboard Race Team, as authorized above.

Part C. Authorization for Emergency Medical Treatment

My signature on this form also conveys my authorization for emergency medical treatment, if needed, for my child/ward, while skiing or snowboarding at any resort named in Part A. I have voluntarily completed the information requested on the reverse side of this form, and I agree to provide any update that may have a bearing on my child/ward’s ability to receive emergency services.

Emergency Medical Treatment Form

I understand my consent for treatment for emergency medical treatment includes such things as x-rays, surgery, hospitalization, medication, ambulance, life flight, and other such treatment or procedure deemed “life saving” by the Ski Patrol, EMT, advisor and/or physician. I understand that emergency life-saving measures are protected under “Good Samaritan” laws, and, as evidenced by my signature on this form, do grant my permission for treatment.

YES NO

In the event emergency medical aid/treatment is required due to illness or injury while participating in ski/boarding activities on the resort property of Bogus Basin, Brundage Mountain, Sun Valley, or Tamarack Resort, I authorize the resort Ski Patrol, Judy Payne (or any other Kuna advisor present) to:

Secure and retain medical treatment and transportation, as needed, for emergency medical treatment.
Release skier/boarder’s personal information, as needed by emergency medical treatment providers. This information may include, but not be limited to: Date of birth, address, phone number, known medical condition(s) and medication(s).

Racer’s Name:___________________________________________ D.O.B.________________

Parent/Guardian:__________________________________________________

Address:________________________________________________________

Mom’s Phone #1:_______________________________ Cell/other:_______________________

Dad’s Phone #1:_______________________________ Cell/other:_______________________

Known medical condition(s), current medication(s), allergies:_______________________________________________________

If parent or guardian cannot be reached, contact the following:

___________________________________ Friend/Relative Phone:______________________

____________________________________ Friend/Relative Phone:_____________________

I understand that other than initial life-saving treatment, treatment will NOT be provided until I, or my contact person, is reached and provides adequate authorization.

Authorized Signature:_______________________________ Date:______________ This authorization is valid for two years, unless revoked in writing.

Print Name:_______________________ Relationship to Racer:__________________

Updated: November 29, 2007

KSD Home Email Directory Lunch Menus Kuna High School Kuna Middle School Ross Fremont H. Teed Hubbard Indian Creek K-3 Reed KSD Services P.A.S.S. Employee Student/Parent Health Help Desk KSD Schools Kuna High School Kuna Middle School Crimson Point Fremont H. Teed Hubbard Indian Creek Reed Ross KSD Departments Assessment Food Service Special Services Maintenance Technology Transportation Information Feedback District Contact Webmaster Email
KHS Home Current Events Facility Schedule Notes Senior Notes Junior Notes Sophomore Notes Freshman Notes Athletics Athletics Home Baseball Boys Basketball Boys Soccer Cheerleaders Cross Country Football Girls Basketball Girls Soccer Golf Softball Tennis Track and Field Volleyball Wrestling Schedule Star Schedule Star Instructions Activities & Clubs Debate FFA Honor Society Science Ski Departments Agricluture Business Family and Consumer Science Fine Arts Foreign Language Health and PE Language Arts Mathematics Science Social Studies Special Ed Work-Based Learning Curriculum Counseling Library Newspaper Handbook Registration Guide Performance School Report Card ISAT Scores KHS Directory Drivers Ed KHS Alumni	*KUNA SNOW SHREDDERS* *SKI AND SNOWBOARD RACE TEAM* SKIER/BOARDER’S PERMISSION TO PARTICIPATE; STANDARD RELEASE OF LIABILITY; AND AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT Part A. Permission to Participate My signature on this form (see reverse side) conveys my permission for my child/legal ward: ______________________________________________, Racer’s Name to participate as a member of the Kuna Ski and Snowboard Race Team. I understand members participate in regular and special ski/snowboard races and fun day/practice events held at Bogus Basin, Brundage Mountain, Sun Valley, and/or Tamarack Resort. I fully understand that ski and snowboard racing and related activities, contain an element of danger, and in some cases, may result in injury ranging from very minor to severe, or, in rare cases, even death. I assume full responsibility for the condition of the equipment, health and action of my child/ward while participating is the activities listed above, and do, hereby, still voluntarily grant my permission, and thereby authorize my child/ward’s participation in the activities of the Kuna Ski and Snowboard Race Team. Part B. Release of Liability I fully understand that my child/ward’s participation, authorized by Part A of this form, is strictly voluntary and, as stated above, that I am solely and completely responsible for my child/ward’s health, actions, and condition of the equipment they use. I understand that my child/ward is expected to conduct him/herself appropriately, follow all ski resort and club team rules of conduct. I understand that helmets are required during all races. I assume all risk and liability associated with my child’s participation in the above described ski/snowboard activities, including any related transportation by bus, van or personal vehicle.Further, my signature on this form signifies that I hereby release the Kuna School District, Judy Payne, and any and all other coaches/advisors/drivers et al, from any and all liability associated with my child/ward’s participation on the Kuna Ski and Snowboard Race Team, as authorized above. Part C. Authorization for Emergency Medical Treatment My signature on this form also conveys my authorization for emergency medical treatment, if needed, for my child/ward, while skiing or snowboarding at any resort named in Part A. I have voluntarily completed the information requested on the reverse side of this form, and I agree to provide any update that may have a bearing on my child/ward’s ability to receive emergency services. Emergency Medical Treatment Form I understand my consent for treatment for emergency medical treatment includes such things as x-rays, surgery, hospitalization, medication, ambulance, life flight, and other such treatment or procedure deemed “life saving” by the Ski Patrol, EMT, advisor and/or physician. I understand that emergency life-saving measures are protected under “Good Samaritan” laws, and, as evidenced by my signature on this form, do grant my permission for treatment. YES NO In the event emergency medical aid/treatment is required due to illness or injury while participating in ski/boarding activities on the resort property of Bogus Basin, Brundage Mountain, Sun Valley, or Tamarack Resort, I authorize the resort Ski Patrol, Judy Payne (or any other Kuna advisor present) to: Secure and retain medical treatment and transportation, as needed, for emergency medical treatment. Release skier/boarder’s personal information, as needed by emergency medical treatment providers. This information may include, but not be limited to: Date of birth, address, phone number, known medical condition(s) and medication(s). Racer’s Name:___________________________________________ D.O.B.________________ Parent/Guardian:__________________________________________________ Address:________________________________________________________ Mom’s Phone #1:_______________________________ Cell/other:_______________________ Dad’s Phone #1:_______________________________ Cell/other:_______________________ Known medical condition(s), current medication(s), allergies:_______________________________________________________ If parent or guardian cannot be reached, contact the following: ___________________________________ Friend/Relative Phone:______________________ ____________________________________ Friend/Relative Phone:_____________________ I understand that other than initial life-saving treatment, treatment will NOT be provided until I, or my contact person, is reached and provides adequate authorization. Authorized Signature:_______________________________ Date:______________ *This authorization is valid for two years, unless revoked in writing.* Print Name:_______________________ Relationship to Racer:__________________ Updated: November 29, 2007
Home Feedback Help Desk Webmaster Copyright © 2006 Kuna School District. All rights reserved.