HOSPITAL RELEASE FORM
2008 Spring Rodeos
We, the parents or guardians of:
________________________________________________________________ (Name of Contestant)(Please Print) give the following hospitals, permission to administer NECESSARY EMERGENCY treatment for injuries he or she may incur while participating in the high school rodeo:
1. 2. 3.
4. 5. 6. 7. 8.
Kingman Community Hospital, Kingman FFA Rodeo, Kingman, KS Scott County Hospital, Tumbleweed HS Rodeo, Scott City, KS Kearny County Hospital, Outlaws HS rodeo, Lakin, KS Western Plains Medical Complex, Dodge City Roundup HS Rodeo, Dodge City, KS Phillips County Hospital, Kansas Biggest Rodeo Phillipsburg HS Rodeo, Phillipsburg, KS Central Kansas Medical Center, Kansas Showcase of Stars, Great Bend, KS Medicine Lodge Memorial Hospital, Medicine Lodge HS Rodeo, Medicine Lodge, KS Stormont –Vail Regional Health Center & St. Francis Health Center, Kansas State High School Rodeo Finals, Topeka, KS
We understand that each contestant must be and is covered by medical insurance. We hereby release the designated local hospital, physicians, medical staff, and the rodeo sponsors from all Liability. Signed: __________________________________________________________ And _____________________________________________________________ (Parent or guardian must sign for all events entered, regardless of age of Contestant)