Consent Request Consent Form Email* Name* First Last Best Phone Number (Emergency Contact)My Child's NameDate MM slash DD slash YYYY Check the appropriate levelChampionshipJVNoviceConsent* I agree to consent my child to attendI request that my child, (named above), be permitted to participate in the above chess event. I fully understand that I, or my representative, will take responsibility for supervising my child during this event. I agree to instruct my child to cooperate and conform with the directions and instructions of the tournament director, organizer or any supervision in charge of the tournament hall, school and school grounds. Should it be necessary for my child to have a medical treatment while participating in this event, I herby give the supervisory personnel permission to use their judgment in obtaining medical services for my child and I give permission to the physician selected by such personnel to render medical treatment deemed necessary and appropriate by such physician(s). I, as parent or representative of this child, hereby release, discharge and hold harmless School which hosts the tournament and all employees, the Tournament Director, volunteers, and board of directors from any claims arising out of or relating to any injury that may result to my child while participating in this event. Pictures from this event may be used in promotional materials. If there are a small number of players in a section, we reserve the right to combine sections. Have a great Tournament experience!CommentsThis field is for validation purposes and should be left unchanged.