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Answers Academy


ATHLETE CONSENT AND MEDICAL RELEASE FORM

ANSWERS ACADEMY ATHLETIC PROGRAM

I, the undersigned parent(s) or guardian(s), hereby consent to my child ­­­­participating in the athletic programs and activities of Answers Academy (the “School”), including but not limited to volleyball, cross country, and basketball sports activity programs provided by the School during the 2023-2024 school year (collectively, the “Program”). I understand that the Program activities will include the following: athletic training and competitions in association with the School’s Program and with events and competitions of other private schools, public schools, or home school associations, and transportation to and from practice or athletic events.

 

I certify that my child is willing and is physically, mentally, and emotionally able to participate in such Program events and activities.

 

I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS THAT MAY BE ENCOUNTERED DURING THE PROGRAM ACTIVITIES OR TRANSPORTATION TO AND FROM THE EVENTS. I do, for myself and for my child, heirs, and assigns, to the fullest extent permitted by law, hereby irrevocably and unconditionally release, acquit, forever discharge, and agree to indemnify and hold harmless Answers Academy and its parent company, Answers in Genesis, their respective directors, officers, teachers, administrators, representatives, agents, employees, and volunteers from any and all liability, actions, causes of actions, claims, expenses, obligations, and damages of any nature whatsoever, which I now have or which may arise in the future, in connection with my child's participation in the described activities or in any other associated activities including, but not limited to, any injury to my child or property, even injury resulting in death.

 

I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws of the Commonwealth of Kentucky and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.


Understanding that my child may need treatment during athletic programs at Answers Academy and other event locations, I hereby authorize the School to administer such first aid as deemed best under the circumstances, and I consent for my child to receive such treatment. I understand that the School will attempt to notify me in the event of an emergency requiring immediate medical care for my child and if the school is unable to notify me, it will have my child treated by a duly qualified physician at the nearest hospital or emergency center. Any medical information provided to the school may be shared with emergency medical personnel. I acknowledge that it is my responsibility to keep my child’s records current to reflect any significant changes, in writing, as they occur, e.g. telephone numbers, work location, emergency contacts, child’s physician and health status, and immunization records.


I further state that I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING RELEASE AND KNOW THE CONTENTS HEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. I understand that this is a legally binding agreement.

Today's date:

May 13, 2024

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Student Consent

I understand that my participation in the Answers Academy Athletics Program depends on appropriate attitude and behavior determined by current school expectations and guidelines as found in AA’s Student Handbook. I will follow the instructions, training rules, and policies implemented by the coaches. If I cannot maintain a proper attitude and follow instructions, school expectations, or guidelines, I will be dismissed from the sports team. If I cannot maintain a C and above grade average, I will also be dismissed from the team. I commit to attend practices and meets and to give my best attitude and effort throughout the season.

First Parent or Guardian's Name

First Name*

Last Name*
First Parent or Guardian's Age Acknowledgment*
First Parent or Guardian's Date of Birth*
I certify that I am 21 years of age or older
First Parent or Guardian's Signature*
Student's Information

Student's Phone Number

Name of the Sport Program *

Student's Grade *
Parent or Guardian's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Student Medical Information

Student's Family Physician *

Physician's Phone Number *

Hospital of Preference

Insurance Policy Holder *

Insurance Company *

Group Number

Policy Number

Please list any Medical Problems

Please list any Allergies (Food or Medication)

Medications (Daily or as needed)
Additional Emergency Contacts (Outside of Parents)

1st Emergency Contact


1st Contact Name (Aside from Parent) *

1st Contact Phone Number *

1st Contact Relationship to Student *

2nd Emergency Contact


2nd Contact Name (Aside from Parent)

2nd Contact Phone Number

2nd Contact Relationship to Student
Parent or Guardian's Spouse Information

Spouse's Name

Spouse's Phone Number
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Parent or Guardian's Phone Number

Phone Number *
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 21 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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