Please type parent's name in the blank below agreeing to the release.

MEDICAL RELEASE: Lebanon Community Unit School District #9 has our permission, in the event of an emergency and in the case we are unavailable, to authorize any physician, nurse practitioner, or medical personnel to examine, interview, test and if necessary, treat my children as they deem advisable. By signing up your student, you as the parent/guardian of the above minor, do for themselves, heirs, executors or assigns, on behalf of and for the said minor, hereby release and discharge Lebanon Community Unit School District #9, its officers, members of its Board of Education, committees, employees and agents, from and against any and all claims, actions, demands, liabilities, losses and expenses (including attorney's fees) relating to any and all damages (including, without limitation, injury to or death of persons and damages or loss of property), caused by, arising out of, or in any way related to, the minor's participation in the Lebanon Greyhounds Basketball Camp.