Forms

2013 Convention - Medical Waiver Form

This medical waiver form is required for all children ages 0-18 participating in the 2013 Children's Program, Preteen Program, Toddler Play Area, and/or Teen Staff Program.

PDF Version of 2013 Convention - Medical Waiver Form

  • Child #1

  • In what program will this child participate?
  • Please list any allergies or other information the staff might need to know about this child.

  • Child #2

  • In what program will this child participate?
  • Please list any allergies or other information the staff might need to know about this child.

  • Child #3

  • In what program will this child participate?
  • Please list any allergies or other information the staff might need to know about this child.

  • Child #4

  • In what program will this child participate?
  • Please list any allergies or other information the staff might need to know about this child.

  • Child #5

  • In what program will this child participate?
  • Please list any allergies or other information the staff might need to know about this child.

  • Child #6

  • In what program will this child participate?
  • Please list any allergies or other information the staff might need to know about this child.

  • Medical Release / Hold Harmless Agreement

    We, the undersigned (parents or guardians) agree to hold harmless from any liability the Texas Home School Coalition Association, or any other participants, planners, volunteers, or persons involved with the 2013 Children’s Program, Preteen Program, Toddler Play Area and/or Teen Staff Program arising from injury or sickness sustained by my child(ren) during their participation in this year's event.

    In addition, we agree to release our child(ren) to any needed first aid or emergency treatment that appears to be necessary and understand that we will be contacted as soon as is reasonably possible in the event of any serious injury to our child(ren).
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