Please select only one.
Please give complete and accurate information about the athlete’s disabilities and medical
Please select just one.
Will medication be distributed to the athlete during Temecula Special Games?
I, the name mentioned above agree to have him/ her present at the 2020 Temecula Special Games on April 18, 2020. I realize every precaution is taken to eliminate any injuries or hazards, and a competent supervisor is present: however, there is inherent risk in participating in this event. In the event of an injury, I hereby waive, release and hold harmless from any liability for damages for personal injury including accidental death, as well as from claims for property damage which may arise in
connection with the above named activity, against the supervisor, the City of Temecula, Temecula Valley Unified School District, its officers, agents, employees and volunteers. In case of accident or other emergency, personnel of the Community Services Department and/or its agents are
hereby authorized to secure medical care deemed necessary as a result of accident or injury for the participant. I further agree to pay any and all costs incurred as a result of said treatment. I further permit the use of activity/event photography and/or video for media promotion.
I, mentioned above the undersigned guardian/fan of the athlete mentioned above, agree to stay in the football stadium at the Temecula Special Games on April 18th. I understand that my athlete will not be able to participate if I am not on site during the event. If I leave the football stadium, my athlete will need to leave as well. I have read and understand the above.
This field is not part of the form submission.
* indicates a required field