2020 State Winter Games Registration

Permission Slip and Medical Information for State Winter Games 2020 Games

Permission to attend and participate in Illinois State Special Olympics Winter Games 2017
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  • I, as the Parent/Guardian give my expressed, written consent to any and all Coaches and volunteers of KCSO Family and Friends to take my child (athlete's name above) held Tuesday February 4, 2020 through Friday February 7, 2020 at the Chestnut Mountain Ski Resort in Galena, Illinois. The undersigned acknowledges voluntary assumption of the risk of injury, damage or loss, both known and unknown, involved with participating in this trip including transportation to and from the activity, and I/we am/are prepared to solely assume all associated with participation in this trip. Therefore, in consideration of the permission extended to my child (athelete's name above) to participate in this trips (I/we) and (my/our) agents, representatives, assigns, heirs, and successors, hereby release, hold harmless and indemnify the KCSO Family & Friends, it’s agents representatives, officers, assigns, and successors from any and all claims, demands, actions, or causes of action, whether developed or undeveloped, known or unknown, past, present, or future, including, but now limited to, any or all damages, costs, personal injuries, including death, disabilities, direct or indirect medical expenses, pain and suffering, and attorney’s fees arising out of or in any way connected with participation in this trip.

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  • Typing your name here serves as online signature