Medical Emergency


Apr 29, 2024 05:38 AM



The undersigned gives permission to Encore Academy of Dance, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health. I request that our doctor/physician be called. Please include doctor/physical phone number below in the comments field.