I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE, AND IT IS WITH MY FULL KNOWLEDGE AND CONSENT THAT THE ABOVE APPLICANT MAY TAKE PART IN THIS PROGRAM. I WILL NOT HOLD THE PROGRAM, ITS PRINCIPALS, OR REPRESENTATIVES RESPONSIBLE FOR ANY INJURY MY CHILD MAY SUSTAIN WHILE PARTICIPATING IN THIS PROGRAM.

I, BEING THE LEGAL PARENT OR LEGAL GUARDIAN OF THE ABOVE NAMED MINOR, DO HEREBY APPOINT ANY BALDWINSVILLE STING BASKETBALL COACH TO ACT ON MY BEHALF IN AUTHORIZING UNEXPECTED MEDICAL CARE, SURGICAL CARE, OR HOSPITALIZATION FOR THE ABOVE NAMED MINOR DURING MY ABSENCE FROM 9/20/18 THROUGH 09/19/19.

MEDICAL WAIVER & AUTHORIZATION