Medical Release Form - JSU Marching Southerners

Marching Southerners Health Release Form

This form is required to be completed in order to participate in the Marching Southerners

Name(Required)

First Last

Date Of Birth(Required)

Section(Required)

Emergency Contact 1(Required)

First Last

Emergency Contact Phone Number 1(Required)

Emergency Contact 2(Required)

First Last

Emergency Contact Phone Number 2(Required)

Medical Conditions/Allergies

List Any Medications(Required)

Anything The Nurse May Need To Know