Opp High School Football - O-Line Sports



Opp High School Football

Insurance and Permission Form

2008-2009

My son, _______________________ has permission to play football for Opp High School.

Parent/Guardian Signature_______________________________________

At Opp High School, we try to furnish all the good equipment your son needs. However, we need your help with insurance. The school insurance we can get has very limited coverage. Therefore, we are asking you to please use your home health insurance. Please select one of the following choices:

(1) My son _____________________________ will use our personal insurance from home. _______Yes ________No. ________________________ Parent signature.

Name of carrier and policy number:____________________________________

(2) We would like to purchase school insurance at a cost of $39.00 ($20 to be paid by parent/guardian and $19 to be paid by school)

_______Yes ________No. _________________________ Parent signature.

Should your son need medical assistance while at football practice or at a football game, we need your written permission to seek that medical assistance.

_______Yes , Opp High School may seek medical assistance for my son.

_______No, Opp High School may not seek medical assistance for my son.

__________________________________ Parent Signature

Thank you for allowing your son to play football at Opp High School. We pledge to be fair and to make every effort to look after his physical well-being. However, we cannot insure your son against physical injury or death while participating in football. You should be aware that you and your son assume the risk and responsibility for any injuries or death resulting from football participation and that Opp City Schools is not responsible for medical expenses or any other damage as a result of such injuries or death.

Thank you,

Jack Whigham

Head Football Coach/Athletic Director

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