I am the parent/legal guardian of the child named below. I hereby permit Salem Christian School’s Athletic Trainers and its personnel to deliver health care and treatment to my child at **Salem Christian School/Salem Christian School Athletics** (name of school/program) providers (athletic trainers, physical therapists, physicians, point of contact, etc.) during practices and games. Such health care and treatment may include providing first aid, initial management of injuries, referral of injuries, injury management, rehabilitation, musculoskeletal screening, evaluation, and treatment as may be deemed necessary or advisable by Salem Christian School’s Athletic Trainers personnel for my child. I understand that this consent will remain in effect until my child ceases to be a member of the Program or until it is revoked by me by sending a written notification to: 

Nothing contained in this consent form shall in any way require or suggest that a child shall be required to seek care with Salem Christian School’s Athletic Trainers, any physician, or any affiliate of that organization at any time whatsoever. Families are free to seek care for any injury/illness at any hospital, health care facility, provider, or physician. Nothing contained in this consent is intended to require and nothing herein shall be construed to require the family or the Program to make or influence referrals to, or otherwise generate business for, Salem Christian School’s Athletic Trainers, any physician, or any affiliate.