DNOW 2020 Registration

DNOW Registration

Parent or Guardian Info
Medical Information and Instructions
Doctor/Insurance Information
Please email copy of front and back of insurance card to kweeks@westashevillebaptist.org
As a parent and/or guardian, I do herewith authorize treatment under the direction of any licensed physician of the following minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me by phone at the number(s) listed below. The undersigned assumes responsibility for any costs connected with such treatment and hereby releases West Asheville Baptist Church, Kyle Weeks and all chaperones of responsibility.

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