Emergency Contact Form - Montelibretti 2024
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Email *
Full Name Rider *
Class *
Emergency Contact (Full name) *
Emergency Contact Number *
Relation with the Rider *
Allergies and other. Important information to know *
THANK YOU!
I hereby give the assigned representatives of the ANAC - Montelibretti Eventing Staff permission to inform my Emergency Contact as set out above of my condition in case of emergency. This includes any injuries sustained, my current medical status, and the medical facility to which I may be transported all as the Show Staff deems fit and necessary under the circumstances and to the degree to which the Show Staff has the relevant information. The Show Staff in no way assumes any responsibility or liability for my medical status or health or for the consequences of the Show Staff divulging this information to my Emergency Contact. 
A copy of your responses will be emailed to the address you provided.
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