Medical Consent Form
(please complete this form and bring
it with you to camp)
The undersigned represents that he/she is a custodial parent and/or the legal
guardian of_________________________, who is a camp member at Bell Athletics in
Jonesboro, AR, and as such is authorized to fully consent to medical care and
treatment for such minor child.
That the undersigned agrees and hereby consents to allow Bell Athletics to
obtain reasonable emergency medical care and treatment
for________________________ in the unlikely event that such medical care and
treatment becomes necessary.
That the undersigned executes this consent with the understanding that Bell
Athletics shall consult with and rely upon the advice of one or more physicians
in determining the need for such emergency medical care and treatment.
___________________________________DATE_____________
Custodial Parent and/or Guardian Signature