The undersigned(s) being the lawful parent(s) and/or guardian(s) of the above child, hereby consent to the participation by the child in all Rodney Hoops/Harbor Impact activities conducted by Rodney Hoops/Harbor Impact and to the participation of the child in all events related to said activities.
The undersigned hereby further authorize(s) any of the staff, employees, agents and representatives of Rodney Hoops/Harbor Impact to provide for, approve and authorize any health care at any hospital, emergency room, doctor's office or other institution, employ any physicians, dentists, nurses or other person whose services may be needed for such health care, review and if necessary disclose the contents of any medical records, execute any consent form required by medical, dental or other health authorities incident to the provision of medical, surgical,or dental care to the child. Health care shall include, but not be limited to the administration of anesthesia, x-ray, examination, performance of operations, diagnostic and other procedures.
The undersigned(s) hereby further authorize(s) emergency transportation by either Rodney Hoops/Harbor Impact personnel if necessary by ambulance or other emergency vehicle.
If there is no medical emergency, the staff will first use reasonable efforts to contact the parent(s) and /or guardian(s) before administering or authorizing any treatment.
Notwithstanding other provisions in this consent form, Rodney Hoops/Harbor Impact shall not have the authority to withhold or withdraw life-sustaining procedures for the child.
This event put on by Rodney Hoops/Harbor Impact ensures that the children are consistently well supervised. However, accidents do happen. The undersigned(s) assume(s) all risk of injury or harm to the child associated with participation in the Harbor Impact open run and forever discharge Rodney Hoops/Harbor Impact and it's staff, employees, and agents of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect of death, injury, loss or damage to the child, or by the child, howsoever caused, arising or to arise by reason of or during the child's participation in the Harbor Impact open run.