ATHLETIC DEPARTMENT
McClain High School - Greenfield, Ohio

ATHLETIC INJURY RELEASE

Desiring not to participate in the insurance program offered for athletic by McClain High School, Greenfield, Ohio,
I, We as a parent, parents, or guardian of (Student Athlete name) _________________________________ release the McClain High School Athletic Department from any financial obligation of the above mentioned student due to any injury occurring while practicing for, traveling to or from, or competing in any interscholastic competition during this school year.

Date:
_____________________________

Date Signature of Parent or Guardian
________________________________________

Address of Parent or Guardian
________________________________________

________________________________________

This form must be on file in the Athletic Director’s Office before a student can participate in interscholastic athletic.

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