OSC - Medical Information (2020/2021 Season)

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Skaters First Name *

Skaters Last Name *

Does your child have any allergies we should be aware of? *

Health Card Number *

Emergency Contact #1 - Name and Phone Number *

Emergency Contact #2 - Name and Phone Number *

I give the Otonabee Skating Club and any member of it's executive and/or coaching staff to act as guardian to my child in the case of an accident during the skating season. This acting is for any medical treatment deemed necessary in my absence. I will not hold the Otonabee Skating Club and/or it's proprietors and/or executives and/or coaching staff responsible for any accident/losses or damage arising from participation in the club activities. *

Yes

Parent/Guardian Name: *

Date: *

YYYY

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