Contact Information: Player name (REQUIRED) * Parent Email Address * Parent Cell Phone * Texts Yes No In case of emergency please contact: Emergency Contact Name Emergency Contact Phone Secondary Emergency Contact Name Secondary Emergency Contact Phone Medical History / Prescriptions Please list any known medical conditions (past or present) Current medications being taken (including asthma inhalers). Please list any known allergic reactions to medications Please list all other known allergies (ex. peanut, gluten, soy etc). Medical Treatment Waiver In case the need for medical treatment is necessary, please indicate your approval/disapproval for ER treatment. I approve I do not approve