INSTRUCTIONS: Students, parents guardians and chapter advisors must complete this form for each stud 2026

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INSTRUCTIONS: Students, parents guardians and chapter advisors must complete this form for each stud Preview on Page 1

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the student's name in the designated field at the top of the form.
  3. Next, fill in the parent/guardian's name along with their contact information, including street address and phone numbers.
  4. Provide details about the student's doctor, including their name, address, and phone number. This is crucial for any medical emergencies.
  5. Indicate whether the student has medical insurance by filling out the insured's name, insurance company, group number, and policy number.
  6. In the medical conditions section, describe any relevant health issues or allergies that may affect treatment during activities.
  7. Select your permission preference regarding immediate medical treatment by checking one of the provided options.
  8. Finally, ensure all signatures are obtained from both parent/guardian and student before submitting the completed form.

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