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Medical form winston-salem dash youth baseball academy 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Participant Information' section. Enter the participant's name, age, and date of birth using black or blue ink.
  3. Provide the home address, including street, city, state, and zip code. Ensure all details are accurate for emergency contact purposes.
  4. Complete the 'Father/Guardian' and 'Mother/Guardian' sections with names, addresses, and phone numbers for home, work, and cell.
  5. List an emergency contact in case parents cannot be reached. Include their address and phone number.
  6. Fill in the 'Family Physician' and 'Insurance Company' sections along with ID number if applicable.
  7. Address any medical history questions thoroughly. Indicate if the participant is under a provider's care or taking medication.
  8. Review the release of liability and consent for injury sections carefully before signing at the bottom of the form.

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