Parent/Guardian Consent and Acknowledgement of Risk

Students and parent must assess the risks involved in such participation and make their choice to participate in spite of those risks. No amount of instruction, precaution or supervision will totally eliminate all risk of injury. The obligation of the parent and students in making this choice to participate cannot be overstated. There have been accidents resulting in death, paraplegia, quadriplegic, and other very serious permanent physical impairments as a result of athletic competition. By granting permission for your student to participate in athletic competition, you the parent or guardian acknowledge that such risks exists. I hereby give my consent for the name student to participate in the name Interscholastic Athletic Program for the school year indicated at Berkeley High School and to go with a representative of the school on any off-campus trips related to participation in the Interscholastic Athletic Program.

I, undersigned parent/guardian of the student, a minor, do hereby authorize and consent to any X-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital care to be rendered under the general or special supervision and upon the advice of a physician, surgeon, or dentist under the provisions of the Medicine Practice Act, or Dentist Practice Act. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care but is given to provide authority and power for the physician/dentist to render responsibility of the parent/guardian to immediately notify the school in writing of any changes in the information to this form.