Parent Consent Form To Whom It May Concern: I, give my permission for the staff of the Red River Junior Golf, Inc. to seek medical attention for my child, if they feel that is necessary. I WILL NOT hold the golf course or any member of the Red River Junior Golf responsible for any injury to my child. Please list any medical condition your child has below. Pre-existing Medical Conditions:_____________________________________________ Medical Release We the parents of _______________________________, give our consent for emergency medical and surgical treatment of this minor in a licensed hospital, by a licensed physician, should their condition so require it in my absence. I understand that in such case, reasonable attempts would first be made to contact me, time and conditions permitting. Parent/Guardian Signature___________________________________________________ Parent Name (please print)_________________________________ Date_____________ Emergency Contact: Name:_______________________________ Relationship:_________________________ Phone: ______________________ ______________________ _____________________                           Home                                  Work                                Cell Address:_________________________________________________________________ Insurance Company:______________________________________________________ Policy Number:____________________________________________________________ Participant:_______________________________________ Age as of 8-1-10:__________ Address:_________________________________________ Grade going into:__________ City:_________________________ State:___________ Zip Code: _________________ Home Phone:_________________________ Work Phone:________________________ Gender:_____________ Date of Birth:__________________ Email:___________________________________________________________________ Parent's name (print):_______________________________________________________ Parent's Signature:_________________________________________________________