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Printable Medical Release Waivers

Create an accessible Printable Medical Release Waiver to be automatically generated at the end of registration.  Korrio also provides an example medical release waiver.  

Creating Accessible, Printable Medical Release Waivers:

There is always a risk for injury while playing sports, which is why Medical Release Waivers are so important.  Prior to participation Medical Release Waivers are required  by tournaments, leagues, showcases, etc. for each player so that physicians, ambulances and hospitals can provide aid to an injured player. We’re here to help you create easily accessible and printable Medical Release Waivers that are pre-populated with the player’s information. While we focus on showing you how to create Medical Release waivers, this functionality can also help you create many different types of documents.

Our solution saves registrars time and effort by:

  • Automatically generating Medical Release Waivers as parents complete registration
  • Providing parents with easy access to the Waiver by automatically attaching it to the registration confirmation email that is sent after registration is completed
  • Pre-populating relevant player information on the Medical Release Waiver

Create Your Organization’s Medical Release Waiver

1. Access the Agreements page by using the Admin Navigator (Club > Agreements > Create Agreement

2. Enter the following information:

  • Enter the agreement name: Printable 2012-2013 Medical Release Waiver
  • Choose Group members must agree to: The most recent version of the agreement
  • Choose Agreement Type: Offline
  • Agreement Text: Insert your agreement title, relevant fields and Medical Release Waiver text
  • Mail Merge: Insert fields that will auto-populate on the Medical Release Waiver after registration is complete. To insert mail merge, or fields that are automatically filled, click on the Mail Merge icon  

We provide an example of a Medical Release Waiver at the end of this document that you can copy and paste right into the Agreement Text area.

 
3. Preview the Agreement to make sure it looks and reads the way you’d like. Click Save Agreement when you are complete.

Enable the New Agreement in your Registration Program

When creating your registration program, select your Printable Medical Release Waiver in the Agreements sub-section of your program.

*How do parents access these Medical Release Waivers?
  1. Email Confirmation – The completed Medical Release Waiver is attached as a document
  2. Any parent or child can access the Medical Release Waiver directly on their own profile page. Just log in to Korrio, click on the Profile link on the left hand navigation. On the profile page, click Account, then Agreements.

Example Medical Release Waiver

While we provide an example Medical Release Waiver that you can copy and paste into Offline Agreements, it is your responsibility to include Medical Release Waivers that comply with the laws of any applicable State, Local or other governing body organization.

Sports Organization Name

2012-2013 Medical Release Waiver

Participant Information:
First Name: {{{First Name}}}                Last Name: {{{Last Name}}}
Street Address: {{{Street}}}                 City: {{{City}}}                       ZIP: {{{Zip}}}
Date of Birth: {{{Date of Birth}}}          Phone: {{{Phone Number}}}
Participant Medical Information:
Doctor’s Name: {{{Doctor Name}}}
Doctor’s Phone: {{{Doctor Phone}}}
Insurance Name: {{{Insurance Name}}}
Insurance Phone: {{{Insurance Phone}}}
Insurance ID: {{{Insurance ID}}}
Allergies or Special Needs: {{{Allergies or Special Needs}}}
Emergency Contact:           ____________________________
Emergency Contact Phone:  ____________________________
Parent/Guardian Information:
First Name: {{{Parent First Name}}}            Last Name: {{{Parent Last Name}}}
Home Phone: {{{Parent Phone Number}}}     Mobile Phone: {{{Parent Mobile Phone}}}
Email: {{{Parent E-mail}}}
Medical Consent

As the parent/legal guardian, I request that, in my absence, the above‐named player be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x‐ray treatment of the above minor.

I agree to be responsible financially for the cost of such assistance and/or treatment.

Release of Liability and Authorization to Transport
As parent/legal guardian I certify that my child/ward is in good health and able to participate in [Name of Organization] programs and activities (“Programs”). In consideration for [Name of Organization] and its affiliates accepting the player named above (“Player”) for the Programs, I hereby for myself, my child/ward, and our heirs, executors, administrators and personal representatives, release, discharge, waive, hold harmless and/or otherwise indemnify [Name of Organization] its Board Members, agents, employees, coaches, managers, contractors, and other volunteers, affiliated organizations, sponsors, and their employees and associated personnel, including the owners of fields and facilities utilized for the Programs, from any and all liability and/or claims by or on behalf of the Player as a results of the Player’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.

PLAYER’S SIGNATURE: ________________________________   DATE:_____________

AND, unless Player is over 18 years of age:

GUARDIAN’S NAME: __________________________________

GUARDIAN’S SIGNATURE: ______________________________  DATE:_____________

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