Wildcat Marching Band Health Form

Complete the form below or use this link for the interactive PDF (second choice) or printable form (last choice). Please complete PRIOR TO band camp check in. If you need to use the paper form, please either mail it in advance or bring it with you to check in.

Click on the year at the top twice to bring up selection by year. Use the navigation arrows at the top, click on your birth year, then month, then date.

Person to be notified in case of illness or injury:

Consent

I give consent for the University of New Hampshire Wildcat Marching Band staff or related parties to take appropriate action in the event of an emergency. I shall assume all responsibility and expense for any injury received in participation in this activity and give permission to be treated by a licensed physician, should such a service be necessary.

Liability Waiver

In consideration of participation in the University of New Hampshire Wildcat Marching Band (WMB), I give this waiver of liability to the University of New Hampshire (UNH) and its employees, agents, officers, directors, sponsors, volunteers, associates, and affiliates. I understand that there are risks, both foreseeable and unforeseeable, associated with the activities and other aspects of marching band. I understand that some risks may relate to the actions or intentions of the participant and that some risks may relate to the actions or intentions of others, including but not limited to UNH and the WMB. I hereby indemnify and hold harmless UNH and the WMB from any and all liabilities, claims, and damages that may arise from or relating to participation in the band. I intend this waiver of liability to be a complete and unconditional release of all liability on the part of UNH and the WMB to the greatest extent allowed by law.

(we know it won't be pretty!)

Typed parent or guardian's name if student is under 18.

 

 

 

 

 

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