EIVA Medical History and Release Form 1 - City of Rigby: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering the participant's name, birth date, age, and gender in the designated fields. Ensure all information is legible.
Fill in the parent or guardian's contact details, including emergency contact information. This section is crucial for safety during activities.
Provide insurance details, including the primary insurance company and policy number. Indicate whether the policy covers sport-related accidents.
Complete the health history section by answering questions about allergies and previous injuries. Be thorough to ensure accurate medical care if needed.
Sign and date the form where indicated, both as a participant and as a parent or guardian. This confirms understanding and consent for participation.

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